A 30-DAY RISK ASSESSMENT OF GERIATRIC PATIENTS IN THE EMERGENCY DEPARTMENT: A COMPARISON OF ISAR AND TRST SCORES

Introduction: The aim of this prospective observational study was to compare the predictive ability of the Triage Risk Stratification Tool and Identification of Seniors at Risk in identifying elderly people at risk of adverse outcomes (return to the emergency department, hospital admission, and death) within 30 days following discharge from the emergency department. Materials and Methods: 396 patients aged between 65 and 98 (mean 76.89±7.59) accessing the emergency department were evaluated over a 1-month period. Both screening tool were administered in the emergency department by emergency specialist physicians. Risk factors were assigned a score based on their regression co-efficient estimate and a total risk score was created. This score was evaluated for sensitivity and specificity. Results: Of the 396 participants, 198 (50%) were female. A significant correlation was not observed between risk of adverse outcomes and characteristics of the participant (p>0.005). The Identification of Seniors at Risk (cutoff of ≥3) was positive in 61.3% of the patients, whereas 79% were Triage Risk Stratification Tool-positive (cutoff of ≥2). The two scores were significantly correlated and had similar areas under the receiver operating characteristic curves in predicting hospital admission (Identification of Seniors at Risk, 0.63; Triage Risk Stratification Tool, 0.59). Conclusions: The predictive accuracy of the scoring systems for hospital admission after 30 days was significant at cutoff values of ≥3 for Identification of Seniors at Risk and ≥2 for Triage Risk Stratification Tool. The Identification of Seniors at Risk had slightly higher sensitivity and lower specificity than the Triage Risk Stratification Tool. Key Words: Emergency Service, Hospital; Geriatric Assessment; Risk Assessment; Aged.