Screening Tool Risk Score Assessment in the Emergency Department for Geriatric (S‐TRIAGE) in 28‐day mortality
Dublin Core
Title
Screening Tool Risk Score Assessment in the Emergency Department for Geriatric (S‐TRIAGE) in 28‐day mortality
Subject
Mortality, Geriatrics, Triage, Lifesaving intervention
Description
Background The number of older adults with a high risk of frailty and severe illness continues to increase. Moreover,
physiological change and multiple comorbidities are challenging to triage in geriatrics. Therefore, we aimed to evalu-
ate variables to predict 28-day mortality and develop a screening tool to predict mortality and lifesaving intervention
among geriatric patients in the emergency department (ED).
Methods This study was a retrospective, single-center, observational study at the ED of Ramathibodi Hospital,
Bangkok. Patients aged≥65 years who visited the ED between January 2018 and December 2019 were enrolled. In
the development cohort, univariable logistic regression was used to identify predictors of 28-day mortality in older
patients. A predictive model for mortality and the need for lifesaving intervention was developed by multivariable
logistic regression. In addition, the score was validated with internal validation and compared between development
and validation set by chi-square.
Results We enrolled 1393 patients. In the development cohort, among these 1002 patients, 103 (10.3%) of whom
died within 28 days. Malignancy, shock index (SI), systolic blood pressure (SBP)<100 mmHg, and altered menta-
tion were independent risk factors of 28-day mortality. We developed new screening tools named the S-TRIAGE
score, which has the respiratory rate (<11,>22 breaths/min), the ratio of pulse oximetric saturation to the fraction
of inspired oxygen (<420, 420–450), SI (>1, 0.6–0.99), SBP<100 mmHg, body temperature (<36,>37.5 °C), and men-
tal change. The area under a receiver operating characteristic (ROC) curve of the S-TRIAGE score in the validation
cohort was 0.826 [95% confidence interval (95%CI) 0.773–0.879] in predicting mortality and lifesaving intervention,
and the clinical score classified patients into five groups.
Conclusion This study showed malignancy, hypotension, increased SI, and mental status change were predictive
factors for 28-day mortality in older adults in the ED. The screening tool risk score for geriatrics used in this study
is potentially a good predictor of mortality and lifesaving intervention in high-risk older patients in the ED.
Keywords Mortality, Geriatrics, Triage, Lifesaving intervention
physiological change and multiple comorbidities are challenging to triage in geriatrics. Therefore, we aimed to evalu-
ate variables to predict 28-day mortality and develop a screening tool to predict mortality and lifesaving intervention
among geriatric patients in the emergency department (ED).
Methods This study was a retrospective, single-center, observational study at the ED of Ramathibodi Hospital,
Bangkok. Patients aged≥65 years who visited the ED between January 2018 and December 2019 were enrolled. In
the development cohort, univariable logistic regression was used to identify predictors of 28-day mortality in older
patients. A predictive model for mortality and the need for lifesaving intervention was developed by multivariable
logistic regression. In addition, the score was validated with internal validation and compared between development
and validation set by chi-square.
Results We enrolled 1393 patients. In the development cohort, among these 1002 patients, 103 (10.3%) of whom
died within 28 days. Malignancy, shock index (SI), systolic blood pressure (SBP)<100 mmHg, and altered menta-
tion were independent risk factors of 28-day mortality. We developed new screening tools named the S-TRIAGE
score, which has the respiratory rate (<11,>22 breaths/min), the ratio of pulse oximetric saturation to the fraction
of inspired oxygen (<420, 420–450), SI (>1, 0.6–0.99), SBP<100 mmHg, body temperature (<36,>37.5 °C), and men-
tal change. The area under a receiver operating characteristic (ROC) curve of the S-TRIAGE score in the validation
cohort was 0.826 [95% confidence interval (95%CI) 0.773–0.879] in predicting mortality and lifesaving intervention,
and the clinical score classified patients into five groups.
Conclusion This study showed malignancy, hypotension, increased SI, and mental status change were predictive
factors for 28-day mortality in older adults in the ED. The screening tool risk score for geriatrics used in this study
is potentially a good predictor of mortality and lifesaving intervention in high-risk older patients in the ED.
Keywords Mortality, Geriatrics, Triage, Lifesaving intervention
Creator
Praphaphorn Supatanakij1
, Kanruethai Imok1 and Karn Suttapanit1*
, Kanruethai Imok1 and Karn Suttapanit1*
Source
https://doi.org/10.1186/s12245-023-00538-5
Date
2023
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Praphaphorn Supatanakij1
, Kanruethai Imok1 and Karn Suttapanit1*, “Screening Tool Risk Score Assessment in the Emergency Department for Geriatric (S‐TRIAGE) in 28‐day mortality,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12200.