The ISAR-positive patient in urology

Abstract

Since 2015 so-called "ISAR Screening" (Identification of Seniors at Risk) is mandatory for patients older than 75 years being hospitalised in Germany. It remains unclear how these patients identified as suffering from geriatric diseases are further characterised in urology and how this information is applied in the ongoing clinical treatment. From the July 1st to December 31th 2016, 337 patients older than 75 years were subjected to ISAR-screening. The result ("with or without need for geriatric action") was contrasted with the results of further assessments, such as the assessment of the risk of falls, the risk of developing a pressure ulcer or malnutrition, demographic data (e. g. age, hospitalisation status) and urological diagnoses. 102 of 377 Patients were tested as "ISAR-positive" during the period of examination. These patients were significantly older than "ISAR-negative" patients. Additionally, ISAR-positive patients had a significantly higher risk of falling, developing pressure ulcers or malnutrition and were significantly more frequently hospitalised under emergency conditions. Reflecting their multimorbidity, ISAR-positive patients had significantly more diagnoses than ISAR-negative patients. These diagnoses were dominated by oncological and infectious urological diseases. Whereas most of the patients were screened by ISAR-screening according to the entire process, the subsequent assessment was performed in fewer patients. The ISAR-screening identifies the "geriatric" patient in urology, who is threatened by his vulnerability, chronification, loss of autonomy and multimorbidity when being hospitalised. The regular implementation of the systemic approach of applying ISAR-screening and the further assessments into the clinical daily routines of urology constitute the major challenge in the future.