Whate Alexandra, Elliott Jacobi, Carter Dustin, Stolee Paul
School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.
Lawson Health Research Institute, London, ON, Canada.
Can Geriatr J. 2021 Mar 2;24(1):8-13. doi: 10.5770/cgj.24.451. eCollection 2021 Mar.
Paramedics respond to a significant number of non-emergency calls generated by older adults each year. Paramedics routinely assess and screen older adults to determine risk level and need for additional follow-up. This project implemented the interRAI ED Screener into routine care to determine whether the screener and resulting Assessment Urgency Algorithm (AUA) score is useful in predicting adverse outcomes.
We conducted a population-based retrospective study using administrative health data for patients aged 65+ assessed by paramedics from July 2016 to February 2017. Patients were assigned an AUA score and classified into three risk categories. Outcome data including hospitalizations, Emergency Department (ED) visits, home care status, and survival were collected and compared across AUA risk categories using descriptive and analytical statistics.
Of the 2,801 patients screened, 31.9% were classified as high risk, 23.6% as moderate risk, and 44.6% as low risk. Patients who scored in the highest risk category were found to have longer hospital stays, and were more likely to require home care (<.0001). The AUA risk category also predicted survival (<.001).
The AUA predicted multiple adverse outcomes in this population. Use of the AUA by paramedics may aid in earlier identification of those in need of additional intervention and services.
护理人员每年会接到大量由老年人拨打的非紧急电话。护理人员会定期对老年人进行评估和筛查，以确定风险水平和是否需要进一步随访。本项目将interRAI急诊筛查工具应用于常规护理，以确定该筛查工具及由此产生的评估紧急度算法（AUA）评分是否有助于预测不良结局。
我们利用2016年7月至2017年2月护理人员评估的65岁及以上患者的行政健康数据进行了一项基于人群的回顾性研究。为患者分配AUA评分，并将其分为三个风险类别。收集包括住院、急诊科就诊、家庭护理状况和生存情况在内的结局数据，并使用描述性和分析性统计方法对不同AUA风险类别的数据进行比较。
在筛查的2801名患者中，31.9%被归类为高风险，23.6%为中度风险，44.6%为低风险。被归类为最高风险类别的患者住院时间更长，且更有可能需要家庭护理（<.0001）。AUA风险类别也能预测生存情况（<.001）。
AUA可预测该人群中的多种不良结局。护理人员使用AUA可能有助于更早识别那些需要额外干预和服务的患者。
