P-191: Evaluation of convergent and predictive validity of the interRAI Emergency Department Screener? to identify the need for geriatric assessment in emergency departments

摘要

Introduction: Orientation after discharge of older people admitted in emergency departments (ED) is central to determine their futuremedical care. Nurse's screening of the need for geriatric assessment is crucial to identify patients requiring further referral for comprehensive geriatric assessment and appropriate geriatric follow-up. Different tools exist to identify the risk of complex healthcare and the need for geriatric assessment. The purpose of this study was to investigate the convergent and predictive validity of the interRAI Emergency Department Screener~? (EDS). Methods: This prospective observational study was conducted in the ED of a tertiary university hospital over a 4-month period. Enrolled patients were aged 75 years and over, excluding patients requiring immediate care. The EDS and brief geriatric assessment (BGA) were conducted by a research nurse. Data on discharge destination after ED stay, length of hospital stay, and 30-day readmission were collected. Results: Patients (N = 202) were aged 83.2 ± 5.4 years, 57% were women, and 44% lived alone. EDS was only weakly correlated with BGA results (r = 0.18, p = 0.01) in identifying patients requiring further comprehensive assessment. EDS had poor sensitivity to predict hospitalization (29%), a prolonged ([ 30 days) hospital stay (50%), and 30-day readmission (26%). In multivariate analysis, EDS was not associated with hospitalization (AdjOR = 0.69; 95% CI [0.31-1.52]) or 30-day readmission (AdjOR = 1.85; 95% CI [0.54-6.38]). Conclusions: EDS performance were poor in both convergent and predictive validity analyses. Further research is required to enhance the identification of older people requiring further assessment.