Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany.
Department for Trauma Surgery, Klinikum Hochsauerland, Arnsberg, Germany.
Clin Interv Aging. 2022 Mar 31;17:309-316. doi: 10.2147/CIA.S344689. eCollection 2022.
The German Society for Geriatrics recommends the "ISAR" questionnaire as a screening tool for patients ≥70 for geriatric screening in emergency rooms. Although the ISAR-score is collected routinely in the "AltersTraumaRegister DGU" (ATR-DGU), to date less is known about the predictive value of the "ISAR"-score in geriatric trauma patients.
Currently, 84 clinics participate in the ATR-DGU. This evaluation is limited to the subgroup of proximal femur fractures from 2016-2018. Patients ≥70 years, who underwent surgery for a hip fracture are included in the ATR-DGU. In this evaluation, the influence of the "ISAR"-score on mortality, length of stay, mobility and the destination of discharge was examined.
Overall 10,098 patients were included in the present study. The median age was 85 years (interquartile range (IQ) 80-89 years). According to the ISAR-score 80.6% (n=8142) of the patients were classified as geriatric patients (cut off "ISAR"-score ≥2 points). These group of patients had a length of stay of 16 days (IQ10.1-22.1) compared to the non-geriatric patient cohort showing a length of stay of 15 days (IQ10.1-20.1). Patients showing an ISAR-score ≥2 had an increased risk of being discharged to a nursing home (OR 8.25), not being able to walk (OR 12.52) and higher risk of mortality (OR 3.45).
The "ISAR"-score shows predictive power for the length of stay, mobility, hospital mortality and discharge after hospital in the collective of geriatric trauma patients. It therefore seems suitable as a screening tool for geriatric trauma patients in the emergency department and should be considered in this context.
德国老年医学学会推荐“ISAR”问卷作为急诊科 70 岁以上老年患者进行老年筛查的工具。虽然“ISAR”评分在“老年创伤登记 DGU（ATR-DGU）”中常规收集，但到目前为止，对于老年创伤患者“ISAR”评分的预测价值知之甚少。
目前，有 84 家诊所参与了 ATR-DGU。本评估仅限于 2016-2018 年近端股骨骨折的亚组。接受髋关节骨折手术的年龄≥70 岁的患者被纳入 ATR-DGU。在本次评估中，研究了“ISAR”评分对死亡率、住院时间、活动能力和出院去向的影响。
本研究共纳入 10098 例患者。中位年龄为 85 岁（四分位间距（IQR）80-89 岁）。根据 ISAR 评分，80.6%（n=8142）的患者被归类为老年患者（截断值“ISAR”-评分≥2 分）。与非老年患者队列相比，这些患者的住院时间为 16 天（IQR10.1-22.1），而非老年患者的住院时间为 15 天（IQR10.1-20.1）。ISAR 评分≥2 的患者有更高的入住疗养院（OR 8.25）、无法行走（OR 12.52）和更高的死亡率（OR 3.45）风险。
“ISAR”评分对老年创伤患者的住院时间、活动能力、院内死亡率和出院后具有预测能力。因此，它似乎适合作为急诊科老年创伤患者的筛查工具，在这种情况下应予以考虑。
