de Gelder et al reported models for outcomes of an older adult in the Emergency Department. One model predicts composite adverse outcomes. The authors are from Leiden University, Alrijne Hospital Erasmus MC and Institute of Evidence-Based Medicine in Older Age in The Netherlands.
Patient selection: age >= 70 years
Exclusion: red code (highest urgency); lack of informed consent
Outcome: functional decline or mortality at 90-day follow-up
Parameter:
(1) age in years
(2) arrival by ambulance
(3) number of different medications
(4) needs help with bathing or showering
(5) history of hospital admission in the past 6 months
(6) needed help prior to ED visit
(7) history of dementia
Parameter
Finding
Points
age in years
0.293 * ((age) / 5)
arrival in ambulance
no
0
yes
0.477
number of different medications
0.044 * (number)
needs help bathing
no
0
yes
0.665
history of hospital admission
no
0
yes
0.404
needed help prior to ED visit
no
0
yes
0.716
history of dementia
no
0
yes
-0.794
X =
= SUM(points for all 7 parameters) - 6.557
probability of adverse outcome =
= 1/(1+EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.73.
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