Comparison of Frailty Screening Instruments in the Emergency Department

Rónán O’Caoimh, Maria Costello, Cliona Small, Lynn Spooner, Antoinette Flannery, Liam O’Reilly, Laura Heffernan, Edel Mannion, Anna Maughan, Alma Joyce, D. William Molloy and John O’Donnell
Additional contact information
Rónán O’Caoimh: Clinical Sciences Institute, National University of Ireland, Galway, Costello Road, H91 TK33 Galway City, Ireland
Maria Costello: Clinical Sciences Institute, National University of Ireland, Galway, Costello Road, H91 TK33 Galway City, Ireland
Cliona Small: Clinical Sciences Institute, National University of Ireland, Galway, Costello Road, H91 TK33 Galway City, Ireland
Lynn Spooner: Centre for Gerontology and rehabilitation, University College Cork, St Finbarr’s Hospital, Douglas Road, T12 XH60 Cork City, Ireland
Antoinette Flannery: Clinical Sciences Institute, National University of Ireland, Galway, Costello Road, H91 TK33 Galway City, Ireland
Liam O’Reilly: Department of Emergency Medicine, University Hospital Galway, Newcastle Rd, H91 YR71 Galway City, Ireland
Laura Heffernan: Department of Emergency Medicine, University Hospital Galway, Newcastle Rd, H91 YR71 Galway City, Ireland
Edel Mannion: Clinical Sciences Institute, National University of Ireland, Galway, Costello Road, H91 TK33 Galway City, Ireland
Anna Maughan: Primary, Community and Continuing Care, Shantalla Health Centre, Costello Rd, H91 YR71 Galway City, Ireland
Alma Joyce: Primary, Community and Continuing Care, Shantalla Health Centre, Costello Rd, H91 YR71 Galway City, Ireland
D. William Molloy: Department of Geriatric and Stroke Medicine, University Hospital Galway, Newcastle Rd, H91 YR71 Galway City, Ireland
John O’Donnell: Department of Emergency Medicine, University Hospital Galway, Newcastle Rd, H91 YR71 Galway City, Ireland

IJERPH, 2019, vol. 16, issue 19, 1-13

Abstract: Early identification of frailty through targeted screening can facilitate the delivery of comprehensive geriatric assessment (CGA) and may improve outcomes for older inpatients. As several instruments are available, we aimed to investigate which is the most accurate and reliable in the Emergency Department (ED). We compared the ability of three validated, short, frailty screening instruments to identify frailty in a large University Hospital ED. Consecutive patients aged ≥70 attending ED were screened using the Clinical Frailty Scale (CFS), Identification of Seniors at Risk Tool (ISAR), and the Programme on Research for Integrating Services for the Maintenance of Autonomy 7 item questionnaire (PRISMA-7). An independent CGA using a battery of assessments determined each patient’s frailty status. Of the 280 patients screened, complete data were available for 265, with a median age of 79 (interquartile ±9); 54% were female. The median CFS score was 4/9 (±2), ISAR 3/6 (±2), and PRISMA-7 was 3/7 (±3). Based upon the CGA, 58% were frail and the most accurate instrument for separating frail from non-frail was the PRISMA-7 (AUC 0.88; 95% CI:0.83–0.93) followed by the CFS (AUC 0.83; 95% CI:0.77–0.88), and the ISAR (AUC 0.78; 95% CI:0.71–0.84). The PRISMA-7 was statistically significantly more accurate than the ISAR ( p = 0.008) but not the CFS ( p = 0.15). Screening for frailty in the ED with a selection of short screening instruments, but particularly the PRISMA-7, is reliable and accurate.

Keywords: older people; frailty; emergency department; screening; sensitivity; specificity (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (5)

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