Department of Geriatrics, Hospital Meyriez and Tafers, HFR, University Fribourg, Fribourg, Switzerland.
Ageing Clinical Research, Department of Internal Medicine II, University Hospital Cologne, Cologne, North Rhine Westphalia, Germany.
Aging Clin Exp Res. 2019 Dec;31(12):1839-1842. doi: 10.1007/s40520-018-1105-8. Epub 2019 Jan 8.
The number of older patients admitted to emergency departments (ED) increases continuously. The Identification of Seniors at Risk (ISAR) score is currently recommended to screen patients in German ED, but its appropriateness is being criticized. ISAR scores and clinical characteristics from 98 emergency admissions (EA), 80 from acute geriatrics (AG) and 89 from a geriatric rehabilitation (GR) unit were compared retrospectively. No significant differences were found between groups, being the ISAR score positive in 87.7% of EA, 94.9% of AG and 94.4% of GR cases. None of positively identified geriatric patients in the EA was transferred to the geriatric ward of competence. EA patients showed significantly higher number of functional impairments (p = 0.001) and higher BI score (p < 0.0001) compared to AG and GR groups. A higher ISAR score threshold and additional functional information might be needed to better select patients in need of prompt treatment by a geriatric team.
越来越多的老年患者被收入急诊科（ED）。目前，德国 ED 推荐使用识别老年人风险（ISAR）评分来筛选患者，但该评分的适当性受到质疑。本研究回顾性比较了 98 例急诊入院（EA）、80 例急性老年病（AG）和 89 例老年康复（GR）患者的 ISAR 评分和临床特征。各组间无显著差异，EA、AG 和 GR 组中 ISAR 评分阳性的比例分别为 87.7%、94.9%和 94.4%。在 EA 中，经 ISAR 评分识别为老年患者的患者无一例被转至有能力的老年病房。与 AG 和 GR 组相比，EA 患者的功能障碍数量显著更多（p=0.001），BI 评分更高（p<0.0001）。可能需要更高的 ISAR 评分阈值和额外的功能信息，以便更好地选择需要老年团队及时治疗的患者。
