The Risk Instrument for Screening in the Community (RISC): a new instrument for predicting risk of adverse outcomes in community dwelling older adults

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dc.contributor.authorO'Caoimh, Rónán
dc.contributor.authorGao, Yang
dc.contributor.authorSvendrovski, Anton
dc.contributor.authorHealy, Elizabeth
dc.contributor.authorO'Keeffe, Gabrielle
dc.contributor.authorCronin, Una
dc.contributor.authorIgras, Estera
dc.contributor.authorO'Herlihy, Eileen
dc.contributor.authorFitzgerald, Carol
dc.contributor.authorWeathers, Elizabeth
dc.contributor.authorLeahy-Warren, Patricia
dc.contributor.authorCornally, Nicola
dc.contributor.authorMolloy, D. William
dc.contributor.funderHealth Service Executive, Ireland
dc.date.accessioned2016-01-15T15:45:15Z
dc.date.available2016-01-15T15:45:15Z
dc.date.issued2015-07-30
dc.description.abstractBACKGROUND: Predicting risk of adverse healthcare outcomes, among community dwelling older adults, is difficult. The Risk Instrument for Screening in the Community (RISC) is a short (2-5 min), global subjective assessment of risk created to identify patients' 1-year risk of three outcomes: institutionalisation, hospitalisation and death. METHODS: We compared the accuracy and predictive ability of the RISC, scored by Public Health Nurses (PHN), to the Clinical Frailty Scale (CFS) in a prospective cohort study of community dwelling older adults (n = 803), in two Irish PHN sectors. The area under the curve (AUC), from receiver operating characteristic curves and binary logistic regression models, with odds ratios (OR), compared the discriminatory characteristics of the RISC and CFS. RESULTS: Follow-up data were available for 801 patients. The 1-year incidence of institutionalisation, hospitalisation and death were 10.2, 17.7 and 15.6 % respectively. Patients scored maximum-risk (RISC score 3,4 or 5/5) at baseline had a significantly greater rate of institutionalisation (31.3 and 7.1 %, p < 0.001), hospitalisation (25.4 and 13.2 %, p < 0.001) and death (33.5 and 10.8 %, p < 0.001), than those scored minimum-risk (score 1 or 2/5). The RISC had comparable accuracy for 1-year risk of institutionalisation (AUC of 0.70 versus 0.63), hospitalisation (AUC 0.61 versus 0.55), and death (AUC 0.70 versus 0.67), to the CFS. The RISC significantly added to the predictive accuracy of the regression model for institutionalisation (OR 1.43, p = 0.01), hospitalisation (OR 1.28, p = 0.01), and death (OR 1.58, p = 0.001). CONCLUSION: Follow-up outcomes matched well with baseline risk. The RISC, a short global subjective assessment, demonstrated satisfactory validity compared with the CFS.en
dc.description.sponsorshipen
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleid92
dc.identifier.citationO’CAOIMH, R., GAO, Y., SVENDROVSKI, A., HEALY, E., O’CONNELL, E., O’KEEFFE, G., CRONIN, U., IGRAS, E., O’HERLIHY, E., FITZGERALD, C., WEATHERS, E., LEAHY-WARREN, P., CORNALLY, N. & MOLLOY, D. W. 2015. The Risk Instrument for Screening in the Community (RISC): a new instrument for predicting risk of adverse outcomes in community dwelling older adults. BMC Geriatrics, 15:92, 1-9.http://dx.doi.org/10.1186/s12877-015-0095-zen
dc.identifier.doi10.1186/s12877-015-0095-z
dc.identifier.endpage9en
dc.identifier.issn1471-2318
dc.identifier.journaltitleBMC Geriatricsen
dc.identifier.startpage1en
dc.identifier.urihttps://hdl.handle.net/10468/2187
dc.identifier.volume15en
dc.language.isoenen
dc.publisherBiomed Central Ltd.en
dc.rights© 2015 O'Caoimh et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http:// creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.en
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.subjectScreeningen
dc.subjectFrailtyen
dc.subjectRisken
dc.subjectAdverse outcomesen
dc.subjectRisk Instrument for Screening in the Community (RISC)en
dc.subjectClinical Frailty Scale (CFS)en
dc.subjectPublic health nurses (PHNs)en
dc.subjectElderly peopleen
dc.subjectPrognostic significanceen
dc.subjectSurprise questionen
dc.subjectFrailtyen
dc.subjectMortalityen
dc.subjectDeclineen
dc.titleThe Risk Instrument for Screening in the Community (RISC): a new instrument for predicting risk of adverse outcomes in community dwelling older adultsen
dc.typeArticle (peer-reviewed)en
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