Does the identification of seniors at risk (ISAR) score effectively select geriatric patients on emergency admission?

Aging Clin Exp Res. 2019 Dec;31(12):1839-1842. doi: 10.1007/s40520-018-1105-8. Epub 2019 Jan 8.

Abstract

The number of older patients admitted to emergency departments (ED) increases continuously. The Identification of Seniors at Risk (ISAR) score is currently recommended to screen patients in German ED, but its appropriateness is being criticized. ISAR scores and clinical characteristics from 98 emergency admissions (EA), 80 from acute geriatrics (AG) and 89 from a geriatric rehabilitation (GR) unit were compared retrospectively. No significant differences were found between groups, being the ISAR score positive in 87.7% of EA, 94.9% of AG and 94.4% of GR cases. None of positively identified geriatric patients in the EA was transferred to the geriatric ward of competence. EA patients showed significantly higher number of functional impairments (p = 0.001) and higher BI score (p < 0.0001) compared to AG and GR groups. A higher ISAR score threshold and additional functional information might be needed to better select patients in need of prompt treatment by a geriatric team.

Keywords: Emergency admission; Geriatric patients; ISAR; Selection for acute geriatric treatment.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Geriatric Assessment / methods*
  • Geriatric Assessment / statistics & numerical data
  • Humans
  • Male
  • Retrospective Studies
  • Risk Assessment / methods