Enhancing emergency department triage for older patients: a prospective study on the integration of the identification of seniors at risk

Enhancing emergency department triage for older patients: a prospective study on the integration of the identification of seniors at risk

Older adults are a growing demographic in emergency departments (EDs) worldwide, yet traditional triage systems often fail to account for their unique risks, leading to under-triage and adverse outcomes. The Identification of Seniors at Risk (ISAR) tool offers a pragmatic approach to enhance risk stratification, but its integration into ED triage systems remains underexplored.

Among 973 patients completing follow-up, 38.1% had an ISAR score ≥ 2. Older patients (≥ 75 years) were more likely to be classified as high risk and had significantly higher rates of adverse outcomes, including ICU admission and 30-day mortality. The revised triage system slightly improved discriminative ability in patients aged ≥ 65 years (AUC 0.697 to 0.714), with stable performance maintained in those aged ≥ 75 years (AUC 0.703). Sensitivity declined slightly, while specificity improved.

Lanxin Ouyang, Shuzhen Yu, Ziwei Hu, Yin Lin & Di Liu

https://link.springer.com/article/10.1186/s12873-025-01253-5

https://link.springer.com/journal/12873

03 june 2025

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