Abstract
Introduction.– Feasible tools for multidimensional geriatric screening in the emergency department (ED) are presently lacking. This study therefore evaluated the diagnostic value of a newly developed emergency geriatric screening (EGS) tool. Methods.– A brief EGS tool was developed based on a literature review for short screening tools of cognition, mobility, and activities of daily living (ADL), and recommended for the 795 patients aged≥75 years admitted to the ED at Bern University Hospital during an intervention period of 4 months. The 752 patients admitted during the 4months prior to this period served as control (pre-post design). Diagnoseswere classifiedbasedonEDdischarge reports. In patients transferred to subsequent inpatient hospital care (n=219), length of stay (LOS) was recorded. Results.– During the intervention period, EGS was performed in 338 of the 795 (42.5%) patients. Reasons for non-performancewere non-feasibility due to patient reason (n=194) and logistic reasons (n=263). The number of persons with abnormal screening result was 170 (50.3%) for cognition, 227 (67.2%) for mobility, and 195 (57.7%) for ADL. The number of personswith related diagnoseswas higher during the intervention period as compared to the control period (e.g., cognitive diagnoses in 15.8% as compared to 12.2% of all admitted patients, P=0.05). EGS findings predicted in-hospital LOS (time-ratio per increase of one limited domain 1.26, 95%CI 1.05–1.51, P=0.01). Key conclusions.– The introduction of a short, newly developed EGS resulted in a modest, but promising increase in the detection of potentially overlooked geriatric problems. Adaptationswithmethods to enhance feasibility (e.g., integration in a software system) and to ensure clinical benefit (e.g., management steps associated with abnormal findings) might lead to a successful and effective method of geriatric screening in emergency care.
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