Health outcome of older hospitalized patients in internal medicine environments evaluated by Identification of Seniors at Risk (ISAR) screening and geriatric assessment.

GND
121994131X
ORCID
0000-0001-7541-7503
Affiliation
Department of Neurology, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany. anne-carina.scharf@uk-essen.de.
Scharf, Anne-Carina;
GND
1072436620
LSF
58510
Affiliation
Department of Neurology, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany.
Gronewold, Janine;
Affiliation
Nursing Headquarters, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany.
Dahlmann, Christian;
Affiliation
Department of Nephrology, Geriatric and Internal Medicine, Alfried Krupp Hospital Ruettenscheid-Essen, Alfried-Krupp-Straße 21, 45131, Essen, Germany.
Schlitzer, Jeanina;
GND
172197155
LSF
16039
Affiliation
Department of Nephrology, University Hospital Essen, University Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany.
Kribben, Andreas;
GND
1071577948
LSF
14605
Affiliation
Department of Gastroenterology and Hepatology, Faculty of Medicine, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany.
Gerken, Guido;
GND
122860489
LSF
57589
Affiliation
Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, Hufelandstraße 55, 45147, Essen, Germany.
Rassaf, Tienush;
GND
123343909
LSF
58465
Affiliation
Department of Neurology, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany.
Kleinschnitz, Christoph;
GND
140826114
Affiliation
Department of Geriatrics, University Hospital Essen, Germaniastraße 1-3, 45356, Essen, Germany.
Dodel, Richard;
Affiliation
Department of Nephrology, Geriatric and Internal Medicine, Alfried Krupp Hospital Ruettenscheid-Essen, Alfried-Krupp-Straße 21, 45131, Essen, Germany.
Frohnhofen, Helmut;
GND
124495648
Affiliation
Department of Neurology, University Hospital Essen, University of Duisburg-Essen, Hufelandstraße 55, 45147, Essen, Germany. dirk.hermann@uk-essen.de.
Hermann, Dirk M.

Background: Hospitals are in need of valid and economic screening and assessment tools that help identifying older patients at risk for complications which require intensified support during their hospital stay.

Methods: Five hundred forty-seven internal medicine in-patients (mean age 78.14 ± 5.96 years; 54.7% males) prospectively received Identification of Seniors at Risk (ISAR) screening. If screening results were positive (ISAR score ≥ 2), a comprehensive geriatric assessment (CGA) was performed. We explored sensitivity and specificity of different ISAR and CGA cutoffs. Further, we analyzed the risk of falls and how patients got discharged from hospital.

Results: ISAR+/CGA abnormal patients spent more days in hospital (16.1 ± 14.5), received more nursing hours per day (3.0 ± 2.3), more hours of physiotherapy during their hospital stay (2.2 ± 3.2), and had more falls (10.1%) compared to ISAR+/CGA normal (10.9 ± 12.3, 2.0 ± 1.2, 1.2 ± 4.3, and 2.8%, respectively, all p ≤ 0.016) and ISAR- (9.6 ± 11.5, 2.3 ± 4.5, 0.7 ± 2.0, and 2.2%, respectively, all p ≤ 0.002) patients. ISAR+/CGA abnormal patients terminated their treatment regularly with being discharged back home less often (59.6%) compared to ISAR+/CGA normal (78.5%, p = 0.002) and ISAR- (78.2%, p = 0.056) patients. ISAR cutoff≥2 and CGA defined as abnormal in case of impairment of ADL plus another CGA domain achieved best sensitivity/specificity.

Conclusions: Abnormal geriatric risk screening and assessment are associated with longer hospital stay and higher amount of nursing and physiotherapy during hospital stay, greater risk of falling, and a lower percentage of successfully terminated treatment in older in-patients.

Cite

Citation style:
Scharf, A.-C., Gronewold, J., Dahlmann, C., Schlitzer, J., Kribben, A., Gerken, G., Rassaf, T., Kleinschnitz, C., Dodel, R., Frohnhofen, H., Hermann, D.M., 2019. Health outcome of older hospitalized patients in internal medicine environments evaluated by Identification of Seniors at Risk (ISAR) screening and geriatric assessment. https://doi.org/10.1186/s12877-019-1239-3
Could not load citation form.

Rights

Use and reproduction:
This work may be used under a
CC BY 4.0 LogoCreative Commons Attribution 4.0 License (CC BY 4.0)
.

Export