Validity of the Identification Seniors At Risk Tool (ISAR) in Predicting the Risk of Re-admitting Elderly in Sabzevar Emergency Wards

M. Lesaei, A. Ghanbari, R. Akrami, Z. Estaji
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Abstract

Introduction : The number of elderly people admitted through the emergency department is rapidly increasing, which has a significant and serious impact on emergency care and costs. In order to identify correctly and preventively the elderly who are at greater risk of being readmitted to the emergency wards, we examined the validity of the ISAR tool in this area. Method: In this correlational study, 264 elderly men and women 60 years and older who were discharged from the Emergency wards of “Vasei”, “Emdad” and “Heshmatieh” Hospitals were studied. They were selected by random sampling in 1397 and were included in the study and followed for 3 months. Data were collected using demographic questionnaire and ISAR tool and analyzed by SPSS v.19 software to evaluate the validity of the tool. Results: The mean age of the sample group was approximately 72 years. The ISAR tool for predicting elderly re-admission one month after emergency discharge had 31% sensitivity and 88% specificity (PPV = 42%, NPV = 82%, AUC = 59%), two months after had 36% sensitivity and 85% specificity (PPV = 43%, NPV = 81%, AUC = 0.60) and three months after had 58% sensitivity and 77% specificity (PPV = 52%, NPV = 81%, AUC = 0.67). Conclusion: Our study showed that the ISAR tool lacked validity to predict elderly re-admission in the short-term after discharge from emergency wards (1to3months).
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风险识别老年人工具(ISAR)在预测Sabzevar急诊室老年人再入院风险中的有效性
导读:急诊科收治的老年人数量正在迅速增加,这对急诊护理和费用产生了重大而严重的影响。为了正确和预防性地识别有更大风险再次进入急诊室的老年人,我们检查了ISAR工具在这一领域的有效性。方法:对从“Vasei”、“Emdad”和“Heshmatieh”医院急诊科出院的264名60岁及以上老年男性和女性进行相关研究。他们于1997年被随机抽取并纳入研究,随访3个月。采用人口统计问卷和ISAR工具收集数据,采用SPSS v.19软件进行分析,评价工具的有效性。结果:样本组的平均年龄约为72岁。ISAR预测急症出院后1个月老年人再入院的敏感性为31%,特异性为88% (PPV = 42%, NPV = 82%, AUC = 59%), 2个月后敏感性为36%,特异性为85% (PPV = 43%, NPV = 81%, AUC = 0.60), 3个月后敏感性为58%,特异性为77% (PPV = 52%, NPV = 81%, AUC = 0.67)。结论:我们的研究表明,ISAR工具在预测老年人急诊病房出院后短期(1 ~ 3个月)再入院方面缺乏有效性。
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