Turkish adaptation of the ISAR (Identification of Seniors at Risk) test for detecting the frail elderly at risk admitted to the emergency department: A reliability and validation study

Turkish Adaptation of the ISAR (Identification of Seniors At Risk) Test for Detecting the Frail Elderly at Risk Admitted to the Emergency Department: A Reliability and Validation Study Background: The ISAR diagnostic tool is a questionnaire created to predict adverse outcomes in patients presenting to the emergency department. The aims of this study are to test predictive validity of the ISAR tool in Turkish, to evaluate the acuity of predicting emergency department admissions and to measure the acuity of diagnosing for frailty that results morbidity and mortality and limitation in activities of daily living in the elderly. Methods: This study is a prospective observational and diagnostic accuracy study performed between dates 01.01.2021-30.01.2021. 356 participants aged 65 and over who applied to the emergency department were included and the patients' emergency admissions, hospitalizations, regressions in activities of daily living, and mortality were recorded from the 30th day to the 180th day after their admission to the emergency department. The data were analyzed with the SPSS 23.0 program. Precision of measuring the early and late negative results of the ISAR diagnostic tool and re-admissions of patients to the emergency department was calculated. In addition, the ISAR diagnostic tool was compared with the PRISMA-7 questionnaire to measure its diagnostic accuracy in predicting frailty. Results: The precision of the ISAR diagnostic tool to predict adverse outcomes in early and late periods has been found to be acceptable but, re-admission to the emergency department has weak acuity in both the early and late period. The sensitivity of the ISAR diagnostic tool for the diagnosis of frailty was %88,55 and the specificity was %75,26 (AUC 0.902). Conclusions: It can be decided whether the patients are frail or not with the ISAR diagnostic tool, which can be done easily for all patients aged 65 and over who apply to the emergency department. Recognition of frail patients will not only help the emergency room physician to plan for hospitalization and discharge, but also will allow to reduce the risk of patients returning to the emergency department, as well as mortality and morbidity. Key words: ISAR, frailty, emergency department, elderly