Examining the utility and accuracy of the interRAI Emergency Department Screener in identifying high‐risk older emergency department patients: A Canadian multiprovince prospective cohort study
Abstract Objectives We set out to determine the accuracy of the interRAI Emergency Department (ED) Screener in predicting the need for detailed geriatric assessment in the ED. Our secondary objective was to determine the discriminative ability of the interRAI ED Screener for predicting the odds of d...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-02-01
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| Series: | Journal of the American College of Emergency Physicians Open |
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| Online Access: | https://doi.org/10.1002/emp2.12876 |
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| author | Fabrice I. Mowbray George Heckman John P. Hirdes Andrew P. Costa Olivier Beauchet Debra Eagles Jeffrey J. Perry Samir Sinha Patrick Archambault Hanting Wang Michaela Jantzi Paul Hebert |
| author_facet | Fabrice I. Mowbray George Heckman John P. Hirdes Andrew P. Costa Olivier Beauchet Debra Eagles Jeffrey J. Perry Samir Sinha Patrick Archambault Hanting Wang Michaela Jantzi Paul Hebert |
| author_sort | Fabrice I. Mowbray |
| collection | DOAJ |
| description | Abstract Objectives We set out to determine the accuracy of the interRAI Emergency Department (ED) Screener in predicting the need for detailed geriatric assessment in the ED. Our secondary objective was to determine the discriminative ability of the interRAI ED Screener for predicting the odds of discharge home and extended ED length of stay (>24 hours). Methods We conducted a multiprovince prospective cohort study in Canada. The need for detailed geriatric assessment was determined using the interRAI ED Screener and the interRAI ED Contact Assessment as the reference standard. A score of ≥5 was used to classify high‐risk patients. Assessments were conducted by emergency and research nurses. We calculated the sensitivity, positive predictive value, and false discovery rate of the interRAI ED Screener. We employed logistic regression to predict ED outcomes while adjusting for age, sex, academic status, and the province of care. Results A total of 5629 older ED patients across 11 ED sites were evaluated using the interRAI ED Screener and 1061 were evaluated with the interRAI ED Contact Assessment. Approximately one‐third of patients were discharged home or experienced an extended ED length of stay. The interRAI ED Screener had a sensitivity of 93%, a positive predictive value of 82%, and a false discovery rate of 18%. The interRAI ED Screener predicted discharge home and extended ED length of stay with fair accuracy. Conclusion The interRAI ED Screener is able to accurately and rapidly identify individuals with medical complexity. The interRAI ED Screener predicts patient‐important health outcomes in older ED patients, highlighting its value for vulnerability screening. |
| format | Article |
| id | doaj-art-ef1d10d3f71e4785a29771ec16d8589b |
| institution | DOAJ |
| issn | 2688-1152 |
| language | English |
| publishDate | 2023-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the American College of Emergency Physicians Open |
| spelling | doaj-art-ef1d10d3f71e4785a29771ec16d8589b2025-08-20T03:21:15ZengElsevierJournal of the American College of Emergency Physicians Open2688-11522023-02-0141n/an/a10.1002/emp2.12876Examining the utility and accuracy of the interRAI Emergency Department Screener in identifying high‐risk older emergency department patients: A Canadian multiprovince prospective cohort studyFabrice I. Mowbray0George Heckman1John P. Hirdes2Andrew P. Costa3Olivier Beauchet4Debra Eagles5Jeffrey J. Perry6Samir Sinha7Patrick Archambault8Hanting Wang9Michaela Jantzi10Paul Hebert11Department of Health Research Methods, Evidence, and Impact McMaster University Hamilton Ontario CanadaSchool of Public Health Science University of Waterloo Waterloo Ontario CanadaSchool of Public Health Science University of Waterloo Waterloo Ontario CanadaDepartment of Health Research Methods, Evidence, and Impact McMaster University Hamilton Ontario CanadaDepartments of Medicine and Research Center of the Geriatric University Institute of Montreal University of Montreal Montreal Quebec CanadaDepartment of Emergency Medicine School of Epidemiology and Public Health University of Ottawa Ottawa Ontario CanadaDepartment of Emergency Medicine School of Epidemiology and Public Health University of Ottawa Ottawa Ontario CanadaDepartment of Medicine Division of Geriatric Medicine Sinai Health and University Health Network Toronto Ontario CanadaDepartment of Family Medicine and Emergency Medicine Université Laval Québec City Ontario CanadaDepartment of Medicine Division of Critical Care Medicine Universite de Montreal Montreal Quebec CanadaSchool of Public Health Science University of Waterloo Waterloo Ontario CanadaDepartment of Medicine Division of Palliative Care Bruyere Research Institute University of Ottawa Ottawa Ontario CanadaAbstract Objectives We set out to determine the accuracy of the interRAI Emergency Department (ED) Screener in predicting the need for detailed geriatric assessment in the ED. Our secondary objective was to determine the discriminative ability of the interRAI ED Screener for predicting the odds of discharge home and extended ED length of stay (>24 hours). Methods We conducted a multiprovince prospective cohort study in Canada. The need for detailed geriatric assessment was determined using the interRAI ED Screener and the interRAI ED Contact Assessment as the reference standard. A score of ≥5 was used to classify high‐risk patients. Assessments were conducted by emergency and research nurses. We calculated the sensitivity, positive predictive value, and false discovery rate of the interRAI ED Screener. We employed logistic regression to predict ED outcomes while adjusting for age, sex, academic status, and the province of care. Results A total of 5629 older ED patients across 11 ED sites were evaluated using the interRAI ED Screener and 1061 were evaluated with the interRAI ED Contact Assessment. Approximately one‐third of patients were discharged home or experienced an extended ED length of stay. The interRAI ED Screener had a sensitivity of 93%, a positive predictive value of 82%, and a false discovery rate of 18%. The interRAI ED Screener predicted discharge home and extended ED length of stay with fair accuracy. Conclusion The interRAI ED Screener is able to accurately and rapidly identify individuals with medical complexity. The interRAI ED Screener predicts patient‐important health outcomes in older ED patients, highlighting its value for vulnerability screening.https://doi.org/10.1002/emp2.12876emergency departmentfrailtygeriatricsinterRAIscreeningvulnerability |
| spellingShingle | Fabrice I. Mowbray George Heckman John P. Hirdes Andrew P. Costa Olivier Beauchet Debra Eagles Jeffrey J. Perry Samir Sinha Patrick Archambault Hanting Wang Michaela Jantzi Paul Hebert Examining the utility and accuracy of the interRAI Emergency Department Screener in identifying high‐risk older emergency department patients: A Canadian multiprovince prospective cohort study Journal of the American College of Emergency Physicians Open emergency department frailty geriatrics interRAI screening vulnerability |
| title | Examining the utility and accuracy of the interRAI Emergency Department Screener in identifying high‐risk older emergency department patients: A Canadian multiprovince prospective cohort study |
| title_full | Examining the utility and accuracy of the interRAI Emergency Department Screener in identifying high‐risk older emergency department patients: A Canadian multiprovince prospective cohort study |
| title_fullStr | Examining the utility and accuracy of the interRAI Emergency Department Screener in identifying high‐risk older emergency department patients: A Canadian multiprovince prospective cohort study |
| title_full_unstemmed | Examining the utility and accuracy of the interRAI Emergency Department Screener in identifying high‐risk older emergency department patients: A Canadian multiprovince prospective cohort study |
| title_short | Examining the utility and accuracy of the interRAI Emergency Department Screener in identifying high‐risk older emergency department patients: A Canadian multiprovince prospective cohort study |
| title_sort | examining the utility and accuracy of the interrai emergency department screener in identifying high risk older emergency department patients a canadian multiprovince prospective cohort study |
| topic | emergency department frailty geriatrics interRAI screening vulnerability |
| url | https://doi.org/10.1002/emp2.12876 |
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