Comparison of the role of different frailty scales in estimating short-term mortality in elderly patients presenting to the emergency department

Comparison of the Role of Different Frailty Scales in Estimating Short-Term Mortality in Elderly Patients Presenting to the Emergency Department. Aim: The aim of this study was to evaluate frailty using the "Edmonton Frailty Scale (EFS)", "Identification of Seniors at Risk (ISAR)" and "Program of Research to Integrate Services for the Maintenance of Autonomy (PRISMA) 7" scales and to examine the short-term (30-day) mortality estimations of these scales in patients aged 65 and over who applied to the emergency department (ED). Methods: This prospective cross-sectional study was carried out in Bursa Uludağ University Medical Faculty Hospital ED between January 1, 2022 and July 31, 2022. Between these dates, 103 cases aged 65 and over who applied to the ED for non-traumatic reasons were included in the study. ISAR, PRISMA-7, and EFS scores were recorded in the ED admissions of the cases. Results: The mean age of the cases was 73.96 ± 7.19 years and 58.3% were male. According to the ISAR score, 94.2% of the cases were at high risk for frailty, according to the PRISMA-7 score, 73.8% of the cases had an increased risk of frailty. According to the ICS score, 30.1% of the people were not frail, while 20.4% were severely frail. Of the cases, 34% were hospitalized in the clinic and 10.7% in the intensive care unit. After the first admission to the ED, 1.9% of the cases died within the first 24 hours, 2.9% within the first 7 days, and 15.5% within the first 30 days. The incidence of malignancy, the frequency of hospitalization, ISAR score, PRISMA 7 score, and EFS score were statistically significantly higher among those who died compared to those who survived the first 30 days (p<0.05). In predicting 30-day mortality, ISAR score had 75% sensitivity and 70.1% specificity at 3< cut-off point, PRISMA-7 score had 68.8% sensitivity and 70.1% specificity at 4< cut-off point adnd EFS score had 100% sensitivity and 52.9% specificity at 7< cut-off point. Conclusion: All three scores were significantly higher among the deceased compared to survivors, and the scores of these scales could predict 30-day mortality at certain cut-off points. In predicting 30-day mortality, EFS was found to be more sensitive than the other two scales. Keywords: Emergency department, elderly, frailty scales, mortality.