Márlon J. R. Aliberti, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Av. Dr. Eneas de Carvalho Aguiar 255, 8º Andar, Bloco 8-Nucleo de Apoio a Pesquisa e Ensino em Geriatria e Gerontologia / Sao Paulo (SP), 05403-000, Brazil. Phone and fax: +551126616236. Email:
J Nutr Health Aging. 2019;23(3):286-290. doi: 10.1007/s12603-018-1152-z.
To estimate whether a 10-minute Targeted Geriatric Assessment (10-TaGA) adds utility to sociodemographic characteristics and comorbidities in predicting one-year mortality in busy acute care settings. We have also compared the performance of 10-TaGA with the Identification of Seniors at Risk (ISAR) scale.
Prospective cohort study.
Geriatric day hospital specializing in acute care in Brazil.
751 older adults aged 79.4 ± 8.4 years (64% female), presenting non-surgical, medical illness requiring hospital-level care (e.g., intravenous therapy, laboratory test, radiology) for ≤ 12 hours.
The 10-TaGA, an easy-to-administer screening tool based on the comprehensive geriatric assessment (CGA), provided a measure of cumulative deficits ranging from 0 (no deficits) to 1 (highest deficit) on admission. Standard risk factors, including sociodemographics (age, gender, ethnicity, income) and the Charlson comorbidity index, were evaluated. The ISAR, a well-validated screening tool, was used for comparison.
During one year of follow-up, 130 (17%) participants died. Compared to the ISAR, 10-TaGA offered better accuracy in identifying older patients at risk of death (area under the receiver operating characteristic curve: [AUC] 0.70 vs 0.65; P = 0.03). In a Cox regression model adjusted for sociodemographics and comorbidities, each 0.1 increment in the 10-TaGA score (range 0-1) was associated with increased mortality (hazard ratio = 1.42, 95% confidence interval 1.27-1.59). The addition of 10-TaGA markedly improved the discrimination of the model, which already incorporated standard risk factors (AUC 0.76 vs 0.71; P = 0.005); adding ISAR (AUC 0.73 vs 0.71; P = 0.09) did not have this marked effect.
The 10-TaGA is an independent predictor of one-year mortality in acute care patients. This multidimensional screening tool offers better accuracy than ISAR when differentiating between older people at low and high risk of death in healthcare settings where providers have limited time and resources.
评估在繁忙的急性护理环境中，10 分钟靶向老年评估（10-TaGA）是否比社会人口统计学特征和合并症更能预测一年的死亡率。我们还比较了 10-TaGA 与识别高危老年人（ISAR）量表的性能。
前瞻性队列研究。
巴西专门从事急性护理的老年日医院。
751 名年龄 79.4 ± 8.4 岁（64%为女性）的老年人，患有非手术性、需要医院级护理的内科疾病（例如静脉治疗、实验室检查、放射学），时间≤12 小时。
10-TaGA 是一种易于管理的筛查工具，基于全面老年评估（CGA），在入院时提供从 0（无缺陷）到 1（最高缺陷）的累积缺陷衡量标准。评估了标准风险因素，包括社会人口统计学因素（年龄、性别、种族、收入）和 Charlson 合并症指数。使用经过充分验证的 ISAR 筛查工具进行比较。
在一年的随访期间，130 名（17%）参与者死亡。与 ISAR 相比，10-TaGA 更能准确识别死亡风险较高的老年患者（接受者操作特征曲线下面积：[AUC]0.70 与 0.65；P = 0.03）。在调整社会人口统计学和合并症的 Cox 回归模型中，10-TaGA 评分每增加 0.1 分（范围 0-1），死亡率就会增加（危险比=1.42，95%置信区间 1.27-1.59）。10-TaGA 的加入显著提高了模型的区分度，该模型已经包含了标准风险因素（AUC 0.76 与 0.71；P = 0.005）；加入 ISAR（AUC 0.73 与 0.71；P = 0.09）则没有这种显著效果。
10-TaGA 是急性护理患者一年死亡率的独立预测因子。在医疗保健环境中，提供者时间和资源有限，当区分低风险和高风险死亡的老年人时，这种多维筛查工具比 ISAR 更准确。
