PRISMA-7 is a predictor of intensive care unit admission and mortality in older patients in an emergency department

Aim

To compare the performance of the Programme of Research on the Integration of Services for the Maintenance of Autonomy (PRISMA-7), which is used to assess the frailty of older patients visiting emergency departments, with the quick Sepsis Related Organ Failure Assessment (qSOFA) and Emergency Severity Index (ESI) in terms of 28-day mortality and intensive care unit (ICU) admission.

Methods

This study was prospective and observational. All patients above the age of 65 who were admitted to the Sivas Republic University Medical Faculty Hospital from March 1 to April 30 in the year 2024 were included in the study. Patients' all-cause mortality values and ICU acceptance rates were evaluated for a 28-day period following their applications.

Results

The area under the receiver operating characteristic curve stood for the 28-day mortality, while the values for PRISMA-7, ESI, and qSOFA were, respectively, 0.81 (95% confidence interval [CI]: 0.78–0.84), 0.78 (95% CI: 0.72–0.83), and 0.71 (95% CI: 0.65–0.77). Our findings have demonstrated PRISMA-7 to be more effective than ESI and qSOFA in terms of hospitalization predictions. However, while it was found to be more effective than qSOFA in mortality predictions, it was determined that, despite PRISMA-7 having a larger AUC than ESI, no meaningful difference existed between PRISMA-7 and ESI.

Conclusions

In conclusion, PRISMA-7, which is thought of as a reliable and valid tool for the determination of frailty in emergency departments, has predictive value for individuals' 28-day mortality risk as well as for their acceptance to the ICU. Geriatr Gerontol Int 2025; 25: 61–66.