Identification of Seniors at Risk (ISAR) for Screening a Geriatric Patient in the Emergency Department

Description

McCusker et al reported the Identification of Seniors at Risk (ISAR) screening tool to identify elderly patients in the Emergency Department who may be at increased for short term deterioration. This patients may benefit from more aggressive management during and after the ED visit. The authors are from St. Mary's Hospital. McGill University and the University of Montreal.

Patient selection: adult >= 65 years of age in the ED

Parameters (asked as a series of yes/no questions):

(1) usual functional status

(2) decline in functional status since current illness started

(3) number of hospital admissions in the past 6 months with a night spent in the hospital

(4) memory

(5) vision

(6) number of medicines taken daily

Parameter	Finding	Points
usual functional status	independent	0
	need help from someone	1
current functional status	no decline	0
	decline	1
number of hospital admissions	0	0
	>= 1	1
memory	not impaired	0
	impaired	1
vision	not impaired	0
	impaired	1
number of medicines	<= 3 per day	0
	> 3	1

total score =

= SUM(points for all 6 parameters)

Interpretation:

• minimum score: 0

• maximum score: 6

• The higher the score the greater the patient's risk.

Performance:

• Suffoletto et al used a score >= 3 as positive, with sensitivity of 87% and specificity of 40%. The area under the ROC curve was 0.69

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Identification of Seniors at Risk (ISAR) for Screening a Geriatric Patient in the Emergency Department

Description

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