Meldon et al reported the Triage Risk Screening Tool (TRST) to identify an older adult in the Emergency Department who is at risk for ED revisit or hospitalization.
Patient selection: adult >= 65 years of age in the Emergency Department
Parameters:
(1) history or evidence of cognitive impairment
(2) difficulty in walking or transferring OR recent falls
(3) number of medications >= 5
(4) visit to the ED in past 30 days OR hospital admission in past 90 days
(5) ED nurse concern (possible abuse or neglect, substance abuse, medication noncompliance, dependency in IADL, etc)
where:
• A sixth item for living alone or no available caregiver was removed.
|
Response
|
Points
|
|
no
|
0
|
|
yes
|
1
|
score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
• A score >= 2 is high risk for subsequent return to the ED or for hospital admission within 30 and 120 days.
Performance:
• The area under the ROC curve for hospitalization within 30 days was 0.72.
