[Prediction of functional decline in elderly patients discharged from the accident and emergency department].
OBJECTIVE
The aim of this study is to investigate the predictive validity of 5 screening tools with respect to functional decline in older persons discharged from the Accident & Emergency Department.


METHODS
The Identification of Seniors at Risk (ISAR), Triage Risk Screening Tool (TRST), questionnaire of Runciman, questionnaire of Rowland and the Voorlopige Indicator voor Plaatsing (VIP) were collected in 83 older persons discharged from the Emergency Department of the University Hospitals of Leuven. Functional decline was derived from the Katz-scale, reflecting the condition 14 days before admission, at admission, 14, 30 and 90 days after discharge.


RESULTS
The screening tools with the highest sensitivity and negative predictive value at 14 days after discharge were the questionnaire of Rowland and the ISAR. Thirty and ninety days after discharge, the ISAR was most sensitive and predictive.


CONCLUSIONS
Sensitivity and negative predictive value are the most important parameters for screening tools. Hence, our study suggests that the ISAR instrument is the most appropriate instrument to predict functional decline in ambulatory older persons admitted to the emergency department. The ISAR can easily be integrated in nursing records and can be systematically employed in older persons at the emergency department.
Geyskens
K
K
Centrum voor Ziekenhuis- en Verplegingswetenschap, Katholieke Universiteit Leuven, Leuven, België.
De Ridder
K
K
Sabbe
M
M
Braes
T
T
Milisen
K
K
Flamaing
J
J
Moons
P
P
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D009426:Netherlands; D010351:Patient Discharge; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D018570:Risk Assessment / Q000379:methods*; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires / Q000592:standards; D013997:Time Factors; D014218:Triage