老年人风险识别工具（ISAR）和分诊风险筛查工具（TRST）在急诊虚弱老年患者中的应用性能。

Performance of Identification of the Seniors At Risk (ISAR) tool and Triage Risk-Screening Tool (TRST) for frail elderly emergency room patients.

机构信息

Department of Internal Medician, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.

出版信息

J Pak Med Assoc. 2021 Feb;71(Suppl 2)(2):S42-S45.

Abstract

OBJECTIVE

This objective of this study was to measure the performance of the identification of the seniors at risk (ISAR) tool and triage risk-screening tool (TRST) for frailty screening in elderly emergency room (ER) patients.

METHODS

A cross-sectional study involving subjects aged 60 years or older was conducted at Cipto Mangunkusumo General Hospital ER from September-November 2018. Frailty was defined by the Forty Item Frailty Index (FI-40). The ISAR and TRST performance were measured as sensitivity, specificity, positive and negative predictive value (PPV and NPV), positive and negative likelihood ratio (LR+ and LR-) and the area under the curve (AUC).

RESULTS

A total of 471 subjects were examined, of which 300 (63.7%) were in the 60-69-year-old subgroup with a median age of 66 years and an age range of 60-95 years. There were 262 (55.6%) male subjects and 445 (94.5%) were non-trauma patients. According to the FI-40, 386 (82%) were classified as frail. ISAR and TRST showed a sensitivity of 87.6% vs 93.8%, a specificity of 58.8% vs 43.5%, a PPV of 90.6% vs 88.3%, an NPV of 51% vs 60.7%, a LR+ of 2.13 vs 1.66 and a LR- of 0.21 vs 0.14, respectively. Both had similar AUCs of 0.8 (95% CI: ISAR [0.76, 0.86] and TRST [0.75, 0.86], p = 0.91).

CONCLUSIONS

ISAR and TRST showed outstanding frailty-screening results among elderly ER patients.

摘要

目的

本研究旨在测量老年人风险识别（ISAR）工具和分诊风险筛查工具（TRST）在老年急诊室（ER）患者中进行虚弱筛查的性能。

方法

2018 年 9 月至 11 月，在 Cipto Mangunkusumo 综合医院 ER 进行了一项涉及 60 岁或以上受试者的横断面研究。脆弱性通过 40 项虚弱指数（FI-40）来定义。ISAR 和 TRST 的性能通过灵敏度、特异性、阳性和阴性预测值（PPV 和 NPV）、阳性和阴性似然比（LR+和 LR-）以及曲线下面积（AUC）来衡量。

结果

共检查了 471 名受试者，其中 300 名（63.7%）在 60-69 岁亚组，中位年龄为 66 岁，年龄范围为 60-95 岁。262 名（55.6%）为男性，445 名（94.5%）为非创伤患者。根据 FI-40，386 名（82%）被归类为虚弱。ISAR 和 TRST 的灵敏度分别为 87.6%和 93.8%，特异性分别为 58.8%和 43.5%，PPV 分别为 90.6%和 88.3%，NPV 分别为 51%和 60.7%，LR+分别为 2.13 和 1.66，LR-分别为 0.21 和 0.14。两者的 AUC 相似，分别为 0.8（95%CI：ISAR [0.76，0.86]和 TRST [0.75，0.86]，p = 0.91）。