The following is a summary of “Evaluating the Prognostic Value of Adding Frailty to Triage Assessment in Elderly Patients with Lower Acuity Presentations in the Emergency Department,” published in the December 2024 issue of Emergency Medicine by Taş et al. 

Frailty in older adults (OAs) visiting the emergency department (ED) is linked to adverse health outcomes and may aid in outcome prediction when assessed alongside triage.  

Researchers conducted a retrospective study to examine the prognostic value of adding frailty assessment to triage evaluation for individuals with low-acuity triage levels.  

They included individuals aged ≥65 admitted to the ED between November 2022 and August 2023 with urgent or non-urgent triage levels. Participants were grouped by triage level and frailty status and were classified using the Clinical Frailty Scale. The prognostic accuracy of triage, frailty, and the combination was evaluated for predicting 30-day mortality, hospitalization, ED revisit ICU admission, and ED disposition.  

The results showed that 1,143 individuals were included, with 837 (73.2%) classified in the urgent triage category and 618 (54.1%) identified as frail. For predicting 30-day mortality, triage demonstrated a relative risk (RR) of 2.22 (95% CI: 1.19-4.15), sensitivity of 86% (95% CI: 76-93), and specificity of 28% (95% CI: 25-30). Frailty showed an RR of 3.88 (95% CI: 2.20-6.84), sensitivity of 82% (95% CI: 71-89), and specificity of 48% (95% CI: 45-51). Combining triage and frailty yielded an RR of 7.08 (95% CI: 2.24-22.37), sensitivity of 95% (95% CI: 86-99), and specificity of 30% (95% CI: 26-33).  

Investigators concluded that adding an assessment of frailty to triage might have enhanced the prognostic performance in predicting 30-day mortality among OAs presenting to the ED with lower acuity triage levels. 

Source: jem-journal.com/article/S0736-4679(24)00399-8/abstract