A comparison of current screening scores in prediction of clinic admission, discharge, after discharge reference to emergency department and mortality in ELDERLY patients applying to the emergency department

Our study was carried out with 127 patients over the age of 65 who agreed to be included after being informed, at the Fırat University Faculty of Medicine, Department of Emergency Medicine. Patients were evaluated with ISAR, PRISMA–7 and Silver Code scoring at their first admission. They were re-evaluated in terms of emergency service admissions and exitus status at 1, 3, and 6 months after the first admission. When the study data are evaluated; PRISMA–7 positivity (p: 0.003) and Siver Code high risk (p: 0.044) were significant in those who died within 1 month after discharge from the emergency room, and PRISMA–7 positivity (p: 0.053) was significant in those who died within 3 months after discharge from the emergency room. It was determined that the high risk of Silver Code (p: 0.025) was significant in the emergency admission at the 3rd month after discharge from the emergency room. It was determined that the ISAR score was not sufficient to show re-admissions and exituses after discharge. In the ROC analysis performed according to the study data, Silver Code was significant (p: 0.05) in demonstrating clinical admission at the first admission; Silver Code was significant (p: 0.02) in showing admission to the intensive care unit at the first admission; none of them is significant on their own in emergency re-admissions; PRISMA – 7>3 (p: 0.0001; sensitivity: 90%) and Silver Code>4 (p: 0.0146; sensitivity 100%) are significant in showing exituses within 1 month; PRISMA – 7>3 (p: 0.0004; sensitivity: 100%), Silver Code>17 (p: 0.0402; sensitivity 83%) and ISAR>3 (p: 0.0002; sensitivity: 83%) in showing exituses within 3 months significant; Silver Code>10 (p: <0.0001; sensitivity: 100%) was found to be significant in demonstrating exituses within 6 months. Age, gender, PRISMA-7, ISAR, Silver Code were not found to be determinative according to the results of Binary Logistic Regression analysis performed by taking age, gender, PRISMA – 7, ISAR, Silver Code as independent variables upon hospitalization and intensive care unit admission. According to the results of Binary Logistic Regression analysis performed by taking age, gender, PRISMA – 7, ISAR, Silver Code as independent variables upon repeated emergency admissions in the 1st, 3rd and 6th months, ISAR was found to be determinant in the 1st month emergency admissions (p: 0.044) ; Age, gender, PRISMA – 7, ISAR, Silver Code were not found to be determinative in the 3rd month emergency admissions; PRISMA–7 was found to be predictive in the 6th month emergency admissions (p: 0.052). According to the results of Binary Logistic Regression analysis performed by taking age, gender, PRISMA – 7, ISAR, Silver Code as independent variables on exitus rates in 1, 3 and 6 months, PRISMA–7 was determined as a determinant in 1-month mortality (p: 0.003); Age, gender, PRISMA – 7, ISAR, Silver Code were not found to be predictive in 3-month mortality; Silver Code was found to be the determinant in 6-month mortality (p: 0.027). As a result; According to the data we obtained from our study with ISAR, Silver Code and PRISMA-7, among the scorings that can be used in frailty screening in the patient group over 65 years of age presenting to the emergency department, Silver Code and PRISMA-7 scores give more information about the prognosis of the patients than the ISAR score. Keywords: Emergency, frailty, ISAR, Silver Code, PRISMA – 7