Screening instruments for identification of vulnerable older adults at the emergency department: A critical appraisal

Carmen S. van Dam; Nadia Moss; Sophie A. Schaper; Marijke C. Trappenburg; Marieke M. ter Wee; Kira Scheerman; Majon Muller; Prabath W.B. Nanayakkara; Mike J.L. Peters

doi:10.52964/AMJA.0716

Screening instruments for identification of vulnerable older adults at the emergency department: A critical appraisal

Carmen S. van Dam^*, Nadia Moss, Sophie A. Schaper, Marijke C. Trappenburg, Marieke M. ter Wee, Kira Scheerman, Majon Muller, Prabath W.B. Nanayakkara, Mike J.L. Peters

^*Corresponding author for this work

Biomechanics

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

Background: Early detection of vulnerable older adults at the emergency department (ED) and implementation of targeted interventions to prevent functional decline may lead to better patient outcomes. Objective: To assess the level of agreement between four frequently used screening instruments: ISAR-HP, VMS, InterRAI ED Screener and APOP. Methods: Observational prospective cohort study in patients ≥ 70 years attending Dutch ED. Results: The prevalence of vulnerability ranged from 19% (APOP) to 45% (ISAR-HP). Overall there was a moderate agreement between the screening instruments (Fleiss Kappa of 0.42 (p<0.001)). Conclusion: Depending on the screening instrument used, either only a small percentage or almost as many as half of the presenting patients will be eligible for targeted interventions, leading to large dissimilarities in working processes, resources and costs.

Original language	English
Pages (from-to)	124-129
Number of pages	6
Journal	Acute medicine
Volume	17
Issue number	3
DOIs	https://doi.org/10.52964/AMJA.0716
Publication status	Published - Sept 2018

Funding

We would like to thank the Emergency Department and Department of Internal Medicine, at both VU University Medical Center and Amstelland Hospital, for their support.

Funders	Funder number
Hallym University Medical Center

Keywords

APOP
Emergency department
InterRAI ED screener
ISAR-HP
Older adults
Screening
VMS
Vulnerability

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10.52964/AMJA.0716

https://acutemedjournal.co.uk/original-articles/screening-instruments-for-identification-of-vulnerable-older-adults-at-the-emergency-department-a-critical-appraisal/

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title = "Screening instruments for identification of vulnerable older adults at the emergency department: A critical appraisal",

abstract = "Background: Early detection of vulnerable older adults at the emergency department (ED) and implementation of targeted interventions to prevent functional decline may lead to better patient outcomes. Objective: To assess the level of agreement between four frequently used screening instruments: ISAR-HP, VMS, InterRAI ED Screener and APOP. Methods: Observational prospective cohort study in patients ≥ 70 years attending Dutch ED. Results: The prevalence of vulnerability ranged from 19% (APOP) to 45% (ISAR-HP). Overall there was a moderate agreement between the screening instruments (Fleiss Kappa of 0.42 (p<0.001)). Conclusion: Depending on the screening instrument used, either only a small percentage or almost as many as half of the presenting patients will be eligible for targeted interventions, leading to large dissimilarities in working processes, resources and costs.",

keywords = "APOP, Emergency department, InterRAI ED screener, ISAR-HP, Older adults, Screening, VMS, Vulnerability",

author = "{van Dam}, {Carmen S.} and Nadia Moss and Schaper, {Sophie A.} and Trappenburg, {Marijke C.} and {ter Wee}, {Marieke M.} and Kira Scheerman and Majon Muller and Nanayakkara, {Prabath W.B.} and Peters, {Mike J.L.}",

year = "2018",

month = sep,

doi = "10.52964/AMJA.0716",

language = "English",

volume = "17",

pages = "124--129",

journal = "Acute medicine",

issn = "1747-4884",

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TY - JOUR

T1 - Screening instruments for identification of vulnerable older adults at the emergency department

T2 - A critical appraisal

AU - van Dam, Carmen S.

AU - Moss, Nadia

AU - Schaper, Sophie A.

AU - Trappenburg, Marijke C.

AU - ter Wee, Marieke M.

AU - Scheerman, Kira

AU - Muller, Majon

AU - Nanayakkara, Prabath W.B.

AU - Peters, Mike J.L.

PY - 2018/9

Y1 - 2018/9

N2 - Background: Early detection of vulnerable older adults at the emergency department (ED) and implementation of targeted interventions to prevent functional decline may lead to better patient outcomes. Objective: To assess the level of agreement between four frequently used screening instruments: ISAR-HP, VMS, InterRAI ED Screener and APOP. Methods: Observational prospective cohort study in patients ≥ 70 years attending Dutch ED. Results: The prevalence of vulnerability ranged from 19% (APOP) to 45% (ISAR-HP). Overall there was a moderate agreement between the screening instruments (Fleiss Kappa of 0.42 (p<0.001)). Conclusion: Depending on the screening instrument used, either only a small percentage or almost as many as half of the presenting patients will be eligible for targeted interventions, leading to large dissimilarities in working processes, resources and costs.

AB - Background: Early detection of vulnerable older adults at the emergency department (ED) and implementation of targeted interventions to prevent functional decline may lead to better patient outcomes. Objective: To assess the level of agreement between four frequently used screening instruments: ISAR-HP, VMS, InterRAI ED Screener and APOP. Methods: Observational prospective cohort study in patients ≥ 70 years attending Dutch ED. Results: The prevalence of vulnerability ranged from 19% (APOP) to 45% (ISAR-HP). Overall there was a moderate agreement between the screening instruments (Fleiss Kappa of 0.42 (p<0.001)). Conclusion: Depending on the screening instrument used, either only a small percentage or almost as many as half of the presenting patients will be eligible for targeted interventions, leading to large dissimilarities in working processes, resources and costs.

KW - APOP

KW - Emergency department

KW - InterRAI ED screener

KW - ISAR-HP

KW - Older adults

KW - Screening

KW - VMS

KW - Vulnerability

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JO - Acute medicine

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ER -

Screening instruments for identification of vulnerable older adults at the emergency department: A critical appraisal

Abstract

Funding

Keywords

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