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

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 use...

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Bibliographic Details
Published in:International journal of environmental research and public health 2022-12, Vol.20 (1), p.290
Main Authors: O'Caoimh, Rónán, McGauran, Jane, O'Donovan, Mark R, Gillman, Ciara, O'Hea, Anne, Hayes, Mary, O'Connor, Kieran, Moloney, Elizabeth, Alcock, Megan
Format: Article
Language:English
Subjects:
Accuracy
Aged
Cognitive ability
Delirium
Emergency medical care
Emergency medical services
Emergency Service, Hospital
Female
Frail Elderly
Frailty
Frailty - diagnosis
Geriatric Assessment
Hospitals
Humans
Male
Mortality
Older people
Patients
Quality of life
Questionnaires
Risk
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Summary: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 ( = 0.026) or VIP-4 ( = 0.047). There was no significant difference between the CFS and PRISMA-7 ( = 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.
ISSN:1660-4601
1661-7827
1660-4601
DOI:10.3390/ijerph20010290