288Geriatric EMergency Services (GEMS): An Acute Floor Frailty Service Model

McFeely, Aoife; Corcoran, R; Jusmanova, Kristina; Kearns, Rachel; Marks, Ellen; Ward, Louise; O'Brien, S.; Fagan, Olga; Nugent, Melinda; O’Dwyer, Orla; Jackson, Kate; Arif, Sidique; Cronin, Ciaran; Reddy, Danielle; Fitzgerald, Helen; O’Callaghan, Maureen; Brennan, Megan Hayes; Nolan, Jane; Ahern, Emer

doi:10.1093/ageing/afy141.50

Cited by 1 publication

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“…The results here however, suggest that the VIP screening tool has both poor diagnostic and predictive validity. The VIP is increasingly being used to screen for frailty with some hospitals incorporating it into the triage document in the ED [42,43]. Previous studies have suggested that the VIP may not be sensitive enough for this, under-recognising frail patients with reduced mobility, acute confusion and polypharmacy, though the design of those papers did not allow them to confirm this [43].…”

Section: Discussionmentioning

confidence: 99%

Frailty Screening in the Emergency Department: Comparing the Variable Indicative of Placement Risk, Clinical Frailty Scale and PRISMA-7

Ó’Caoimh

McGauran

O’Donovan

et al. 2022

IJERPH

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Prompt recognition of frailty in the emergency department (ED) is important to identify patients at higher risk of adverse outcomes. Despite this, few studies examine the diagnostic accuracy of screening instruments for frailty, instead focusing on predictive validity. We compared three commonly used, short frailty screens to an independent comprehensive geriatric assessment (CGA) in an urban University Hospital ED. Consecutive attendees aged ≥70 years were screened by trained raters, blind to the CGA, with the Variable Indicative of Placement risk (VIP), 3 and 4-item versions, Clinical Frailty Scale (CFS) and PRISMA-7. Accuracy was measured from the area under the ROC curve (AUROC). In total, 197 patients were included, median age 79 (±10); 46% were female. Half (49%) were confirmed as frail after CGA. All instruments differentiated frail from non-frail states, although the CFS (AUROC: 0.91) and PRISMA-7 (AUROC: 0.90) had higher accuracy compared to the VIP-4 (AUROC: 0.84) and VIP-3 (AUROC: 0.84). The CFS was significantly more accurate than the VIP-3 (p = 0.026) or VIP-4 (p = 0.047). There was no significant difference between the CFS and PRISMA-7 (p = 0.90). The CFS and PRISMA-7 were more accurate and should be considered in preference to the VIP (3 or 4-item versions) to identify frailty in EDs.

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Section: Discussionmentioning

confidence: 99%