title: [Triage risk screening tool (TRST) in screening elderly patients requiring the intervention of a mobile geriatric team: results of a pilot study].
abstract: Improving care and health course for hospitalized elderly patients is one of the tasks set out in the "Rapport du parcours de santé des PAERPA" (elderly people with or at risk of functional decline). Identification of the needs of a mobile geriatric team (MGT) intervention for the patients remain difficult in emergency department and in medical surgical units. A screening tool is needed and should be simple and fast to use. Its implementation implies that it is efficient and previously validated. The aim of our study was to evaluate the validity and predictive performances of the Triage risk stratification tool (TRST) for identify patients aged over 75 years, requiring the intervention of the MGT. This is a prospective, national, multicenter study including consecutive patients aged 75 years and older, hospitalized in emergency services and medical-surgical units in September and October 2013. The TRST was considered positive when the score was greater than 2 of 5 points. A supplementary question with binary answer (yes/no) was asked to MGT, in order to define if MGT intervention was useful. This issue has served as a "gold standard" for assessing the validity and predictive test performance. In emergency departments, the TRST was performed in 427 patients, 347 were positive. Results showed high sensitivity (79%), and poor specificity (19%) of the test in emergency units, showing that TRST did not permit to identify patients requiring MGT intervention. In contrast, the TRST seems more performant in medical-surgical (n=63 patients) units with good predictive performances (positive predictive value 90% and negative predictive value 87%). The specificity of TRST in emergency services is insufficient to generalize its use. However, performances of the TRST in other units are encouraging to propose a validation as part of a national research project.
authors: Equipe mobile de gériatrie, Pôle de gérontologie clinique, CHU de Bordeaux, Hôpital Xavier Arnozan, Pessac, France.
authors: Sophie
authors: S
authors: Duc
authors: Equipe mobile de gériatrie, CHRU de Strasbourg, France.
authors: Catherine
authors: C
authors: Fernandez
authors: Unité mobile de gériatrie intra-hospitalière, Centre hospitalier Annecy Genevois, Annecy, France.
authors: Bahman
authors: B
authors: Moheb
authors: Unité mobile de gérontologie, Clinique de médecine gériatrique, CHU de Grenoble, France.
authors: Van Mô
authors: VM
authors: Dang
authors: Equipe mobile de gériatrie, Hôpital universitaire Broca, Université René Descartes Paris V, Paris, France.
authors: Frederic
authors: F
authors: Bloch
authors: Equipe mobile de gériatrie, Pôle de gérontologie clinique, CHU de Bordeaux, Hôpital Xavier Arnozan, Pessac, France.
authors: Marie
authors: M
authors: Floccia
authors: Equipe mobile de gériatrie, Pôle de gérontologie clinique, CHU de Bordeaux, Hôpital Xavier Arnozan, Pessac, France.
authors: Marie-Neige
authors: MN
authors: Videau
authors: Centre hospitalier Edmond Garcin, Aubagne, France.
authors: Sandrine
authors: S
authors: Tournier Louvel
authors: Unité mobile de gériatrie, CHRU Brest, France.
authors: Laure
authors: L
authors: Ducastaing
authors: Unité mobile de gérontologie, Clinique de médecine gériatrique, CHU de Grenoble, France.
authors: Pascal
authors: P
authors: Couturier
authors: Equipe mobile de gériatrie, Pôle de gérontologie clinique, CHU de Bordeaux, Hôpital Xavier Arnozan, Pessac, France.
authors: Nathalie
authors: N
authors: Salles
authors: Equipe mobile de gériatrie, Pôle de gérontologie clinique, CHU de Bordeaux, Hôpital Xavier Arnozan, Pessac, France, Equipe mobile de gériatrie, CHRU de Strasbourg, France, Unité mobile de gériatrie intra-hospitalière, Centre hospitalier Annecy Genevois, Annecy, France, Unité mobile de gérontologie, Clinique de médecine gériatrique, CHU de Grenoble, France, Equipe mobile de gériatrie, Hôpital universitaire Broca, Université René Descartes Paris V, Paris, France, Centre hospitalier Edmond Garcin, Aubagne, France, Unité mobile de gériatrie, CHRU Brest, France.
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004632:Emergency Medical Services; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D005853:Geriatrics / Q000379:methods* / Q000592:standards; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011446:Prospective Studies; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D014218:Triage / Q000379:methods*
keywords: elderly; mobile geriatric team; sensitivity; specificity and screening test