Patients in need of comprehensive geriatric assessment: The utility of the InterRAI emergency department screener

Elfa Gretarsdottir; Anna Björg Jonsdottir; Ingibjörg Sigurthorsdottir; Ester Eir Gudmundsdottir; Ingibjörg Hjaltadottir; Iris Bjork Jakobsdottir; Gunnar Tomasson; Palmi V Jonsson; Thordis Thorsteinsdottir

doi:10.1016/j.ienj.2020.100943

Patients in need of comprehensive geriatric assessment: The utility of the InterRAI emergency department screener

Int Emerg Nurs. 2021 Jan:54:100943. doi: 10.1016/j.ienj.2020.100943. Epub 2020 Dec 25.

Authors

Elfa Gretarsdottir¹, Anna Björg Jonsdottir², Ingibjörg Sigurthorsdottir³, Ester Eir Gudmundsdottir⁴, Ingibjörg Hjaltadottir⁵, Iris Bjork Jakobsdottir⁶, Gunnar Tomasson⁷, Palmi V Jonsson⁸, Thordis Thorsteinsdottir⁹

Affiliations

¹ Internal Medicine Services, Landspítali The National University Hospital of Iceland, Iceland; Faculty of Nursing, University of Iceland, Iceland. Electronic address: elfag@landspitali.is.
² Geriatric Department, Landspítali The National University Hospital of Iceland, Iceland.
³ Emergency, Geriatrics, Rehabilitation Service, Landspitali The National University Hospital of Iceland, Iceland.
⁴ Faculty of Nursing, University of Iceland, Iceland.
⁵ Faculty of Nursing, University of Iceland, Iceland; Emergency, Geriatrics, Rehabilitation Service, Landspitali The National University Hospital of Iceland, Iceland.
⁶ Internal Medicine Services, Landspítali The National University Hospital of Iceland, Iceland; Faculty of Nursing, University of Iceland, Iceland.
⁷ Department of Rheumatology, Landspítali The National University Hospital of Iceland, Iceland; Centre for Rheumatology Research, Landspítali The National University Hospital, Iceland; Faculty of Medicine, University of Iceland, Iceland.
⁸ Geriatric Department, Landspítali The National University Hospital of Iceland, Iceland; Faculty of Medicine, University of Iceland, Iceland.
⁹ Faculty of Nursing, University of Iceland, Iceland; Research Institute in Emergency Care, Landspítali The National University Hospital of Iceland, Iceland.

PMID: 33370678
DOI: 10.1016/j.ienj.2020.100943

Abstract

Introduction: The interRAI Emergency Department-Screener (ED-screener) is a risk stratification instrument incorporating functional and social aspects to identify older adults in EDs. The aim was to assess the construct validity and utility of the ED-screener in comparison with more established instruments.

Methods: The ED-screener, Triage Risk Screening Tool (TRST) and Identification of Seniors at Risk (ISAR) were administered to older ED-patients. Construct validity was assessed by correlation with TRST and ISAR. The ED-screener scores that corresponded to the established cut-offs for ISAR and TRST were assessed with linear regression. The sensitivity and specificity of the ED-screener for mortality at 4-months were calculated.

Results: Two hundred patients were included (mean age 78.5 years, 44% male). Majority (85%) lived at home, 43% lived alone and 53% received home care. The scores of 3.02 and 3.01 on ED-screener corresponded to the cut-off score of 2 on the other instruments. The correlation of the ED-screener with ISAR and TRST was 0.56 and 0.41 respectively. A score of 3 on the ED-screener was 100% sensitive and 28% specific for 4-month mortality.

Conclusion: These findings provide support for the construct validity of the ED-screener and its ability to predict outcomes in its intended setting.

Keywords: Comprehensive geriatric assessment; Emergency department; InterRAI ED-screener; Screening.

Publication types

Validation Study

MeSH terms

Aged
Aged, 80 and over
Demography
Female
Geriatric Assessment / methods*
Humans
Male
Mortality / trends
Risk Assessment
Sensitivity and Specificity
Triage