Çelik Şimşek, Türkdoğan Onur, Erdoğan Tayfun, Çelik Pelin
Department of Emergency Medicine, Faculty of Medicine, Sivas Cumhuriyet University, Sivas, Turkey.
Department of Health Programs, Vocational School of Health Services, Sivas Cumhuriyet University, Sivas, Turkey.
Geriatr Gerontol Int. 2025 Jan;25(1):61-66. doi: 10.1111/ggi.15039. Epub 2024 Dec 10.
To compare the performance of the Programme of Research on the Integration of Services for the Maintenance of Autonomy (PRISMA-7), which is used to assess the frailty of older patients visiting emergency departments, with the quick Sepsis Related Organ Failure Assessment (qSOFA) and Emergency Severity Index (ESI) in terms of 28-day mortality and intensive care unit (ICU) admission.
This study was prospective and observational. All patients above the age of 65 who were admitted to the Sivas Republic University Medical Faculty Hospital from March 1 to April 30 in the year 2024 were included in the study. Patients' all-cause mortality values and ICU acceptance rates were evaluated for a 28-day period following their applications.
The area under the receiver operating characteristic curve stood for the 28-day mortality, while the values for PRISMA-7, ESI, and qSOFA were, respectively, 0.81 (95% confidence interval [CI]: 0.78-0.84), 0.78 (95% CI: 0.72-0.83), and 0.71 (95% CI: 0.65-0.77). Our findings have demonstrated PRISMA-7 to be more effective than ESI and qSOFA in terms of hospitalization predictions. However, while it was found to be more effective than qSOFA in mortality predictions, it was determined that, despite PRISMA-7 having a larger AUC than ESI, no meaningful difference existed between PRISMA-7 and ESI.
In conclusion, PRISMA-7, which is thought of as a reliable and valid tool for the determination of frailty in emergency departments, has predictive value for individuals' 28-day mortality risk as well as for their acceptance to the ICU. Geriatr Gerontol Int 2025; 25: 61-66.
比较用于评估急诊科老年患者虚弱程度的自主性维持服务整合研究项目（PRISMA-7）与快速脓毒症相关器官功能衰竭评估（qSOFA）和急诊严重程度指数（ESI）在28天死亡率和重症监护病房（ICU）入住方面的表现。
本研究为前瞻性观察性研究。纳入了2024年3月1日至4月30日入住锡瓦斯共和国大学医学院医院的所有65岁以上患者。在患者就诊后的28天内评估其全因死亡率值和ICU接受率。
受试者工作特征曲线下面积代表28天死亡率，PRISMA-7、ESI和qSOFA的值分别为0.81（95%置信区间[CI]：0.78 - 0.84）、0.78（95%CI：0.72 - 0.83）和0.71（95%CI：0.65 - 0.77）。我们的研究结果表明，在住院预测方面，PRISMA-7比ESI和qSOFA更有效。然而，虽然发现其在死亡率预测方面比qSOFA更有效，但确定尽管PRISMA-7的曲线下面积（AUC）比ESI大，但PRISMA-7与ESI之间不存在有意义的差异。
总之，PRISMA-7被认为是急诊科确定虚弱程度的可靠有效工具，对个体28天死亡风险及其入住ICU具有预测价值。《老年医学与老年病学国际杂志》2025年；25：61 - 66。
