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Frailty Screening in the Emergency Department: Comparing the Variable Indicative of Placement Risk, Clinical Frailty Scale and PRISMA-7

Prompt recognition of frailty in the emergency department (ED) is important to identify patients at higher risk of adverse outcomes. Despite this, few studies examine the diagnostic accuracy of screening instruments for frailty, instead focusing on predictive validity. We compared three commonly use...

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Autores principales: O’Caoimh, Rónán, McGauran, Jane, O’Donovan, Mark R., Gillman, Ciara, O’Hea, Anne, Hayes, Mary, O’Connor, Kieran, Moloney, Elizabeth, Alcock, Megan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9819173/
https://www.ncbi.nlm.nih.gov/pubmed/36612612
http://dx.doi.org/10.3390/ijerph20010290
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author O’Caoimh, Rónán
McGauran, Jane
O’Donovan, Mark R.
Gillman, Ciara
O’Hea, Anne
Hayes, Mary
O’Connor, Kieran
Moloney, Elizabeth
Alcock, Megan
author_facet O’Caoimh, Rónán
McGauran, Jane
O’Donovan, Mark R.
Gillman, Ciara
O’Hea, Anne
Hayes, Mary
O’Connor, Kieran
Moloney, Elizabeth
Alcock, Megan
author_sort O’Caoimh, Rónán
collection PubMed
description Prompt recognition of frailty in the emergency department (ED) is important to identify patients at higher risk of adverse outcomes. Despite this, few studies examine the diagnostic accuracy of screening instruments for frailty, instead focusing on predictive validity. We compared three commonly used, short frailty screens to an independent comprehensive geriatric assessment (CGA) in an urban University Hospital ED. Consecutive attendees aged ≥70 years were screened by trained raters, blind to the CGA, with the Variable Indicative of Placement risk (VIP), 3 and 4-item versions, Clinical Frailty Scale (CFS) and PRISMA-7. Accuracy was measured from the area under the ROC curve (AUROC). In total, 197 patients were included, median age 79 (±10); 46% were female. Half (49%) were confirmed as frail after CGA. All instruments differentiated frail from non-frail states, although the CFS (AUROC: 0.91) and PRISMA-7 (AUROC: 0.90) had higher accuracy compared to the VIP-4 (AUROC: 0.84) and VIP-3 (AUROC: 0.84). The CFS was significantly more accurate than the VIP-3 (p = 0.026) or VIP-4 (p = 0.047). There was no significant difference between the CFS and PRISMA-7 (p = 0.90). The CFS and PRISMA-7 were more accurate and should be considered in preference to the VIP (3 or 4-item versions) to identify frailty in EDs.
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spelling pubmed-98191732023-01-07 Frailty Screening in the Emergency Department: Comparing the Variable Indicative of Placement Risk, Clinical Frailty Scale and PRISMA-7 O’Caoimh, Rónán McGauran, Jane O’Donovan, Mark R. Gillman, Ciara O’Hea, Anne Hayes, Mary O’Connor, Kieran Moloney, Elizabeth Alcock, Megan Int J Environ Res Public Health Article Prompt recognition of frailty in the emergency department (ED) is important to identify patients at higher risk of adverse outcomes. Despite this, few studies examine the diagnostic accuracy of screening instruments for frailty, instead focusing on predictive validity. We compared three commonly used, short frailty screens to an independent comprehensive geriatric assessment (CGA) in an urban University Hospital ED. Consecutive attendees aged ≥70 years were screened by trained raters, blind to the CGA, with the Variable Indicative of Placement risk (VIP), 3 and 4-item versions, Clinical Frailty Scale (CFS) and PRISMA-7. Accuracy was measured from the area under the ROC curve (AUROC). In total, 197 patients were included, median age 79 (±10); 46% were female. Half (49%) were confirmed as frail after CGA. All instruments differentiated frail from non-frail states, although the CFS (AUROC: 0.91) and PRISMA-7 (AUROC: 0.90) had higher accuracy compared to the VIP-4 (AUROC: 0.84) and VIP-3 (AUROC: 0.84). The CFS was significantly more accurate than the VIP-3 (p = 0.026) or VIP-4 (p = 0.047). There was no significant difference between the CFS and PRISMA-7 (p = 0.90). The CFS and PRISMA-7 were more accurate and should be considered in preference to the VIP (3 or 4-item versions) to identify frailty in EDs. MDPI 2022-12-24 /pmc/articles/PMC9819173/ /pubmed/36612612 http://dx.doi.org/10.3390/ijerph20010290 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
O’Caoimh, Rónán
McGauran, Jane
O’Donovan, Mark R.
Gillman, Ciara
O’Hea, Anne
Hayes, Mary
O’Connor, Kieran
Moloney, Elizabeth
Alcock, Megan
Frailty Screening in the Emergency Department: Comparing the Variable Indicative of Placement Risk, Clinical Frailty Scale and PRISMA-7
title Frailty Screening in the Emergency Department: Comparing the Variable Indicative of Placement Risk, Clinical Frailty Scale and PRISMA-7
title_full Frailty Screening in the Emergency Department: Comparing the Variable Indicative of Placement Risk, Clinical Frailty Scale and PRISMA-7
title_fullStr Frailty Screening in the Emergency Department: Comparing the Variable Indicative of Placement Risk, Clinical Frailty Scale and PRISMA-7
title_full_unstemmed Frailty Screening in the Emergency Department: Comparing the Variable Indicative of Placement Risk, Clinical Frailty Scale and PRISMA-7
title_short Frailty Screening in the Emergency Department: Comparing the Variable Indicative of Placement Risk, Clinical Frailty Scale and PRISMA-7
title_sort frailty screening in the emergency department: comparing the variable indicative of placement risk, clinical frailty scale and prisma-7
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9819173/
https://www.ncbi.nlm.nih.gov/pubmed/36612612
http://dx.doi.org/10.3390/ijerph20010290
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