Comparison of frailty screening instruments in the emergency department

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dc.contributor.authorO'Caoimh, Rónán
dc.contributor.authorCostello, Maria
dc.contributor.authorSmall, Cliona
dc.contributor.authorSpooner, Lynn
dc.contributor.authorFlannery, Antoinette
dc.contributor.authorO'Reilly, Liam
dc.contributor.authorHeffernan, Laura
dc.contributor.authorMannion, Edel
dc.contributor.authorMaughan, Anna
dc.contributor.authorJoyce, Alma
dc.contributor.authorMolloy, D. William
dc.contributor.authorO'Donnell, John
dc.date.accessioned2019-10-23T04:37:27Z
dc.date.available2019-10-23T04:37:27Z
dc.date.issued2019-09-27
dc.description.abstractEarly 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.en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleid3626en
dc.identifier.citationO’Caoimh, R., Costello, M., Small, C., Spooner, L., Flannery, A., O’Reilly, L., Heffernan, L., Mannion, E., Maughan, A., Joyce, A., Molloy, D. W. and O’Donnell, J. (2019) 'Comparison of Frailty Screening Instruments in the Emergency Department', International Journal of Environmental Research and Public Health, 16(19), 3626. (13pp.) DOI: 10.3390/ijerph16193626en
dc.identifier.doi10.3390/ijerph16193626en
dc.identifier.eissn1660-4601
dc.identifier.endpage13en
dc.identifier.issn1661-7827
dc.identifier.issued19en
dc.identifier.journaltitleInternational journal of environmental research and public healthen
dc.identifier.startpage1en
dc.identifier.urihttps://hdl.handle.net/10468/8832
dc.identifier.volume16en
dc.language.isoenen
dc.publisherMDPI AGen
dc.relation.urihttps://www.mdpi.com/1660-4601/16/19/3626/htm
dc.rights© 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).en
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.subjectOlder peopleen
dc.subjectFrailtyen
dc.subjectEmergency departmenten
dc.subjectScreeningen
dc.subjectSensitivityen
dc.subjectSpecificityen
dc.titleComparison of frailty screening instruments in the emergency departmenten
dc.typeArticle (peer-reviewed)en
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