Predicting older adults who return to the hospital or die within 30 days of emergency department care using the ISAR tool: subjective versus objective risk factors

Suffoletto, Brian; Miller, Thomas H.; Shah, Rahul; Callaway, Clifton W.; Yealy, Donald M.

doi:10.1136/emermed-2014-203936

Cited by 22 publications

(23 citation statements)

References 32 publications

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“…Twenty-three articles were excluded after the full-text review, leaving nine articles for inclusion in the systematic review. [37][38][39]44,[55][56][57][58]61 A list of excluded studies from the second phase of screening is provided in Supplementary Appendix S3 (see Appendix Table S1). Twelve studies were excluded because they did not meet the full-inclusion criteria (two studies had a non-applicable outcome measure, 54,60 two did not meet age criteria, 29,47 four did not have a formal physical mobility assessment, 30,31,45,46 and six were conducted in a non-ED setting).…”

Section: Study Selectionmentioning

confidence: 99%

Mobility assessments of geriatric emergency department patients: A systematic review

Eagles

Yadav

Perry

et al. 2017

CJEM

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Section: Study Selectionmentioning

confidence: 99%

Mobility assessments of geriatric emergency department patients: A systematic review

Eagles

Yadav

Perry

et al. 2017

CJEM

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“…In the first few months after discharge from the emergency department (ED), adults aged 65 and older are at risk of adverse events, including rapid return to the ED, hospitalization, decline in capacity to perform activities of daily living (ADLs), and death . These outcomes may stem from inadequate care transitions from the ED, including poor communication of discharge instructions, delays in return appointments to a primary care physician (PCP), and unrecognized signs of complications .…”

mentioning

confidence: 99%

Telephone Follow‐Up for Older Adults Discharged to Home from the Emergency Department: A Pragmatic Randomized Controlled Trial

Biese

Busby‐Whitehead

Cai

et al. 2017

J American Geriatrics Society

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“…In summary, this study shows that older people who had contact with the GPC had a relevant problem with frailty. Previous studies on frailty of older persons in the emergency care usually focused on the setting of the emergency department (26)(27)(28)(29) or the general practitioners practice during daytime(30-33). Studies in the last group did not differentiate between regular, chronic and emergency primary healthcare.…”

Section: Discussion Principal Findingsmentioning

confidence: 99%

Older persons are more frail after an emergency care visit to the out-of-hours General Practitioner Cooperative in the Netherlands: a cross sectional descriptive TOPICS-MDS study

Bloemhoff¹,

Schoon²,

Smulders

et al. 2020

Preprint

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Background In the Netherlands community dwelling older people with primary care emergency problems contact the General Practitioner Cooperative (GPC) after hours. However, frailty remains often unobserved with the hazard of adverse health outcomes. The aim of this study was to provide insight in differences between older persons with or without GPC emergency care visits (reference group) regarding frailty and healthcare use.Methods A cross-sectional descriptive study design was based on data from the public data repository: The Older Persons and Informal Caregivers Survey Minimum Dataset (TOPICS-MDS). Frailty in older persons (65+ years, n=32,149) was measured by co-morbidity, functional and psychosocial aspects, quality of life and a frailty index. Furthermore, home care use and hospital admissions of older persons were identified. We performed multilevel logistic and linear regression analysis. A random intercept model was utilized to test differences between groups, and adjustment factors (confounders) were used in the multilevel analysis. Results Older persons with GPC contact were, compared to the reference group, more frail on the domain of co-morbidity (mean difference 0.52 ; 95% CI 0.47-0.57, p <0.0001), functional limitations (mean difference 0.53 ; 95% CI 0.46-0.60, p <0.0001), reported less emotional wellbeing (mean difference -4.10 ; 95% CI -4.59- -3.60, p <0.0001) and experienced less quality of life (mean difference -0.057 ; 95% CI -0.064- -0.050, p <0.0001). Moreover, older persons reported more often limited social function (OR 1.50, 95%CI 1.39-1.62, p <0.0001) and limited perceived health (OR 1.50, 95%CI 1.39-1.62, p <0.0001). Finally, older persons with GPC contact more often used home care (OR 1.37, 95%CI 1.28-1.47, p <0.0001) or were more often admitted to the hospital (OR 2.88, 95%CI 2.71-3.06, p <0.0001). Conclusions Older persons with out-of-hours GPC contact for an emergency care visit were significantly more frail on all domains, more likely to use home care or to be admitted to the hospital, compared to the reference group. Potentially frail older persons seem to require adequate identification of frailty, and support (e.g. advance care planning) before and after a contact with the out-of-hours GPC.

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Predicting older adults who return to the hospital or die within 30 days of emergency department care using the ISAR tool: subjective versus objective risk factors

Cited by 22 publications

References 32 publications

Mobility assessments of geriatric emergency department patients: A systematic review

Mobility assessments of geriatric emergency department patients: A systematic review

Telephone Follow‐Up for Older Adults Discharged to Home from the Emergency Department: A Pragmatic Randomized Controlled Trial

Older persons are more frail after an emergency care visit to the out-of-hours General Practitioner Cooperative in the Netherlands: a cross sectional descriptive TOPICS-MDS study

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