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

Author

Listed:
  • Rónán O’Caoimh

    (Mercy University Hospital, Grenville Place, T12 WE28 Cork, Ireland
    Clinical Research Facility Cork, University College Cork, Mercy University Hospital, T12 WE28 Cork, Ireland)

  • Jane McGauran

    (Mercy University Hospital, Grenville Place, T12 WE28 Cork, Ireland)

  • Mark R. O’Donovan

    (Clinical Research Facility Cork, University College Cork, Mercy University Hospital, T12 WE28 Cork, Ireland)

  • Ciara Gillman

    (Mercy University Hospital, Grenville Place, T12 WE28 Cork, Ireland)

  • Anne O’Hea

    (Mercy University Hospital, Grenville Place, T12 WE28 Cork, Ireland)

  • Mary Hayes

    (Mercy University Hospital, Grenville Place, T12 WE28 Cork, Ireland)

  • Kieran O’Connor

    (Mercy University Hospital, Grenville Place, T12 WE28 Cork, Ireland)

  • Elizabeth Moloney

    (Clinical Research Facility Cork, University College Cork, Mercy University Hospital, T12 WE28 Cork, Ireland)

  • Megan Alcock

    (Mercy University Hospital, Grenville Place, T12 WE28 Cork, Ireland)

Abstract

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.

Suggested Citation

  • Rónán O’Caoimh & Jane McGauran & Mark R. O’Donovan & Ciara Gillman & Anne O’Hea & Mary Hayes & Kieran O’Connor & Elizabeth Moloney & Megan Alcock, 2022. "Frailty Screening in the Emergency Department: Comparing the Variable Indicative of Placement Risk, Clinical Frailty Scale and PRISMA-7," IJERPH, MDPI, vol. 20(1), pages 1-13, December.
    • Handle: RePEc:gam:jijerp:v:20:y:2022:i:1:p:290-:d:1013980
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    References listed on IDEAS

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    1. Rónán O’Caoimh & Maria Costello & Cliona Small & Lynn Spooner & Antoinette Flannery & Liam O’Reilly & Laura Heffernan & Edel Mannion & Anna Maughan & Alma Joyce & D. William Molloy & John O’Donnell, 2019. "Comparison of Frailty Screening Instruments in the Emergency Department," IJERPH, MDPI, vol. 16(19), pages 1-13, September.
    2. Elizabeth Moloney & Duygu Sezgin & Mark O’Donovan & Kadjo Yves Cedric Adja & Keith McGrath & Aaron Liew & Jacopo Lenzi & Davide Gori & Kieran O’Connor & David William Molloy & Evelyn Flanagan & Darren, 2022. "The Diagnostic Accuracy and Clinimetric Properties of Screening Instruments to Identify Frail Older Adults Attending Emergency Departments: A Protocol for a Mixed Methods Systematic Review and Meta-An," IJERPH, MDPI, vol. 19(3), pages 1-15, January.
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    Cited by:

    1. Rónán O’Caoimh & Laura Morrison & Marion Hanley & Caoimhe McManus & Kate Donlon & Patricia Galvin, 2024. "Impact of Frailty on Healthcare Outcomes after Cardioembolic Ischaemic Stroke Due to Atrial Fibrillation," IJERPH, MDPI, vol. 21(3), pages 1-11, February.

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