European Geriatric Emergency Departments Registry Study
Conditions: Geriatric Patients, Emergencies, Length of Stay, Early Warning Score, Hospital Mortality
Sponsor: Gazi University

  
 
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PROTOCOL 
 
                                EGERS 
European Geriatric Emergency Departments Registry Study 
 
On Behalf of the Geriatrics EuSEM Interest Group and the EUSEM 
Research committee  
 
 
 
Protocol Number: ..................... 
 
Status: Version 2.3 
 
Date: 20/09/2020 
 
 
 
 
 
 
 
 
 
 

  
 
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STUDY PROTOCOL 
PROTOCOL NUMBER: ................ 
TITEL:  
 
The European Geriatric Emergency Departments Registry Study 
 
PROMOTER:  
 
European Society of Emergency Medicine (EuSEM).  
The EuSEM office is located at: 
Antwerpsesteenweg 124 B27 
B-2630 Aartselaar, Brussels 
Belgium 
 
 
STUDY COORDINATORS: 
 
 
Principal Investigator: Assoc Prof Dr Mehmet Akif KARAMERCAN, Gazi University Faculty of 
Medicine Emergency Medicine Department, Ankara/TURKEY (EuSEM Research Committee 
Member) 
 
Co-Principal Investigator: Assoc Prof Dr Zerrin Defne DÜNDAR, Konya/TURKEY (EuSEM 
Research Committee Member)  
 
EGERS Steering Committee: 
 
Chair: Mehmet Akif KARAMERCAN (Turkey) 
Co-Chair: Zerrin Defne DÜNDAR (Turkey) 
 
AND COUNTRY PI of THE STUDY 
 
TECHNICAL SECRETARY: 
 
EuSEM Research Committee 

  
 
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1. SUMARY 
 
 
1. STUDY PROMOTER 
 
European Society of Emergency Medicine ( EuSEM).  
The EuSEM office is located at: 
Antwerpsesteenweg 124 B27 
B-2630 Aartselaar, Brussels 
Belgium 
 
 
2. STUDY TITEL 
 
The European Geriatric Emergency Departments Registry Study (EGERS Study) 
 
 
3. STUDY CODE 
           EuSEM …………. 
 
 
4. RESEARCHERS 
 
Physicians of each participating center. 
 
 
5. PARTICIPATING CENTRES 
European Emergency Departments (EDs) 
 
 
6. EVALUTED BY ETHICAL COMMITTEE 
Local Ethical Committees. 
 
 
7. MONITOR RESPONSABLE 
Non applicable.  
 
 
8. TREATMENT 
Non applicable. 
 
 
9. PHASE OF STUDY 
Non applicable. 
 
 

  
 
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10. STUDY OBJETIVE 
Principle Objective: Description of Epidemiologic and Age Related Characteristic of geriatric 
patients presenting to the ED  
Secondary Objective: Determination of the prognostic and predictive values of vital sign 
based triage scores (REMS, MEWS and VIEWS Scores) regarding hospitalization, ICU 
admission and in-hospital mortality for geriatric patients presenting to ED 
 
 
11. DESIGN 
Prospective multicentre observational study. 
 
 
12. DISEASES OF INTEREST 
 
Non applicable. 
 
 
13. OUTCOME VARIABLE 
 
Length of stay in the ED and Length of stay in the hospital if hospitalized.   
           Status at 30 days: alive or dead.   
 
14. STUDY POPULATION AND SAMPLE SIZE 
 
Patients ≥ 65 years of age those presented to EDs with any symptom 
 
Sample is generated with consecutive patients attending to EDs during study period. 
 
 
15. STUDY PERIOD 
From 19th October 2020 to 16th November 2020, seven consecutive days of recruitment. 
 

  
 
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2. GENERAL INFORMATION 
 
 
A.Study Identification 
 
1. Study Code            EuSEM …………. 
 
 
Title:  The European Geriatric Emergency Departments Registry Study  
 
(EGERS Study). 
 
 
 
B. Study Design 
 
Observational study 
 
 
C. Study final products 
 
Non applicable. 
 
 
D. Promoter 
 
 
European Society of Emergency Medicine( EuSEM).  
The EuSEM office is located at: 
Antwerpsesteenweg 124 B27 
B-2630 Aartselaar, Brussels 
Belgium 
 
  
E. Biological samples responsible 
 
Non applicable. 
 
 
F. Study monitors 
 
Non applicable. 
 
G. Researchers and Centers (recruitment still ongoing) 
 
For countries represented in the EUSEM Research network, the country PI is the country Lead 
of the RN.  
 
 
 
 

  
 
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3. INTRODUCTION, HYPOTHESIS AND OBJECTIVES 
 
 
 
3.1 Background 
Due to improved prevention, diagnosis and treatment modalities, life expectancy worldwide has 
risen. The number of adults over 65 years of age who are presenting to emergency services is 
increasing in parallel with the prolongation of the average life expectancy (1). While geriatric 
presentations to emergency services comprise 40–50% of all emergency service presentations in the 
U.S., it has been reported that 3–23% of all emergency service presentations from various regions of 
the country comprise patients of 65 years of age and older (2–4). There are specific management 
practices for patients who are 65 years and older at emergency services due to the presence of co-
morbidities and the change of physiological responses to acute diseases in advanced age (1,2).  
Several risk-scoring systems have been developed to define the severity class of the patient during 
their initial evaluation at emergency services and generally named as Early Warning Scores (5–6). 
Early Warning Scores (EWS) incorporate physiological measurements, which do predict 
outcome although the addition of other simple clinical parameters might further improve the 
sensitivity and specificity of these scores (7). On the other hand all these EWS are simple and easy to 
calculate, making their use appropriate in an emergency setting (7). Of these EWS, the Modified 
Early Warning Score (MEWS), and the Rapid Emergency Medicine Score (REMS) have been widely 
used for many years (8) and The Vital PAC Early Warning Score (VIEWS) score was recently 
developed for the same purpose (9, 10).  
Only a few studies in the literature have evaluated risk-scoring systems for the geriatric patient 
group. Several studies have reported that risk-scoring systems, such as Identification of Seniors at 
Risk (ISAR) and Triage Risk Screening Tool (TRST), which are specifically developed for geriatric 
patients over 65 years who present to emergency services, are not sufficiently effective for evaluating 

  
 
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patients in more severe conditions (11,12). Other studies have reported that the ESI triage 
classification predicts the prognosis correctly in only half of the patients over 65 years of age (7,13). 
In another study that evaluated the MEWS for the geriatric patient group, which was calculated 
during the presentation in emergency services, has been stated to have a prognostic value in terms of 
a poor result (14).  
Previously the TEDGeS (Turkish Emergency Departments Geriatric Scoring Study) pilot study was 
carried out and published (15,16). This study enrolled all geriatric patients (age ≥ 65 years) and 
carried out in 13 centers (University Hospitals, Government Education and Research Hospitals and 
Military Hospital ED) from different cities of Turkey.  
Key findings were: 
 Overall 30 % of hospitalized patients from ED are elderly patients and 30 % of these 
hospitalized patients were ICU hospitalizations 
 In hospital mortality rate is about 6 % which is very high for general hospitalized patients 
 The most common presenting symptoms are related to gastrointestinal systems and about 80 
% of the cases using at least one chronic medication (22.2 % of the cases using more than 4 
chronic medications 
 About 45 % of the cases final diagnosis are related to cardiovascular system and 
gastrointestinal system and nearly 85 % of the hospitalized cases are treated in non-surgical 
clinics (cardiology-pulmonology-internal medicine 65 %) 
 MEWS, VIEWS and REMS scores are significantly high in hospitalized patients compared to 
discharged from ED and also these three scores are high in ICU hospitalized patients 
compared to both ward hospitalized and discharged patients. 

  
 
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 MEWS, VIEWS and REMS scores are significantly high in non-survivors compared to 
survivors. 
 MEWS, VIEWS scores has higher sensitivity and specificity in terms of in-hospital mortality 
 
These results suggest that geriatric patients not only constitute significant proportion of ED 
presentations but also they need more hospitalization. The predictive powers of the MEWS, 
VIEWS and REMS scores for hospitalization and mortality in geriatric patients those 
presented to ED are significantly high and might be concerned in the ED triage of these 
patients. 
 
 
References 
1. Pines JM, Mullins PM, Cooper JK, Feng LB, Roth KE. National trends in emergency 
department use, care patterns, and quality of care of older adults in the United States. J Am 
Geriatr Soc 2013;61:12-7. 
2. Roberts DC, McKay MP, Shaffer A. Increasing rates of emergency department visits for 
elderly patients in the United States, 1993 to 2003. Ann Emerg Med 2008;51:769-74. 
3. Baz U, Satar S, Kozaci N, Acikalin A, Gulen M, Karakurt U. Geriatric patient admissions to 
emergency service. JAEM 2013, in press 
4. Kekec Z, Koc F, Buyuk S. Review of geriatric patients hospitalization in emergency 
department. JAEM 2009;8(3):21-4. 

  
 
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5. Platts-Mills TF, Travers D, Biese K, et al. Accuracy of the Emergency Severity Index triage 
instrument for identifying elder emergency department patients receiving an immediate life-
saving intervention. Acad Emerg Med 2010;17:238-43. 
6. Subbe CP, Kruger M, Rutherford P, Gemmel L. Validation of a modified Early Warning 
Score in medical admissions. QJ Med 2001;94:521-6. 
7. Wheeler 
I, Price 
C, Sitch 
A, Banda 
P, Kellett 
J, Nyirenda 
M, Rylance 
J. 
Early warning scores generated in developed healthcare settings are 
not 
sufficient 
at 
predicting early mortality in Blantyre, Malawi: a prospective cohort study. PLoS One 
2013;8(3): e59830. 
8. Olsson T, Terent A, Lind L. Rapid Emergency Medicine Score: a new prognostic tool for in-
hospital mortality in nonsurgical emergency department patients. J Intern Med 2004;255:579-
87. 
9. Prytherch DR, Smith GB, Schmidt PE, Featherstone PI. ViEWS--Towards a national early 
warning score for detecting adult inpatient deterioration. Resuscitation 2010;81:932-7. 
10. Bleyer AJ, Vidya S, Russell GB, et al. Longitudinal analysis of one million vital signs in 
patients in an academic medical center. Resuscitation 2011;82:1387-92. 
11. Salvi F, Morichi V, Grilli A, et al. Predictive validity of the Identification of Seniors At Risk 
(ISAR) screening tool in elderly patients presenting to two Italian Emergency Departments. 
Aging Clin Exp Res 2009;21:69-75. 
12. Buurman BM, van den Berg W, Korevaar JC, Milisen K, de Haan RJ, de Rooij SE. Risk for 
poor outcomes in older patients discharged from an emergency department: feasibility of four 
screening instruments. Eur J Emerg Med 2011;18:215-20. 

  
 
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13. Lamantia MA, Stewart PW, Platts-Mills TF, et al. Predictive value of initial triage vital signs 
for critically ill older adults. West J Emerg Med 2013;14:453-460. 
14. Cei M, Bartolomei C, Mumoli N. In-hospital mortality and morbidity of elderly medical 
patients can be predicted at admission by the Modified Early Warning Score: a prospective 
study. Int J Clin Pract 2009;63:591-5. 
15. Modified Early Warning Score and VitalPac Early Warning Score in geriatric patients 
admitted to emergency department. Dundar ZD, Ergin M, Karamercan MA, Ayranci K, Colak 
T, Tuncar A, Cander B, Gul M. Eur J Emerg Med. 2016 Dec;23(6):406-412. 
16. Epidemiological characteristics of geriatric patients in emergency departments: Results of a 
multicenter study. Ergin M, Karamercan MA, Ayranci M, Yavuz Y, Yavasi O, Serinken M, 
Acar T, Avcil M, Al B, Bayramoglu A, Durgun HM, Golcuk Y, Arziman İ, Dündar ZD. 
Turkish Journal of Geriatrics 2015; 18(4): 259-65  
 
3.2. Study objectives 
 
MAIN OBJETIVE 
 
The main objective of this project will be  
- 
To determine Epidemiologic and Age Related Characteristics of Geriatric Patients presenting 
to the ED across Europe. 
 
SECONDARY OBJETIVES 
 
- 
To evaluate Early Warning Scoring systems (REMS, MEWS and VIEWS Scores) and 
determine most suitable Geriatric Emergency Medicine Risk Score regarding hospitalization, 
ICU admission and in-hospital mortality for patients 
- 
To determine the most effective triage elements that can be used to predict hospitalization of 
geriatric patients presented to ED 

  
 
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- 
To determine the in hospital mortality and short term mortality rates of the patients above 65 
years of age presenting to the ED across Europe. 
- 
Sub   analysis   of   ED   discharged   patients   versus   admitted   patients   for characteristics, 
comparison to recommended care and re-ED visit. 
- 
Comparison   of   European   data   characteristics, investigation, treatment and outcome to 
similar data in other part of the world. 
 
4. STUDY DESIGN 
 
4.1. Study Design 
 
Prospective non interventional cohort study in European EDs.  
    
5. SELECTION OF CASES 
 
 
5.1. Setting 
 
Hospital Emergency Departments 
 
 
5.2. Population Selected 
 
Patients ≥ 65 years of age those presented to EDs with any symptom 
 
 
5.3. Inclusion criteria  
 
 Consecutive geriatric patient presenting to the ED with any symptom 
 65 years or older 
 
5.3. Exclusion criteria 
 
 No acceptance to participated 
 End of life patients 
5.4. Variables included on the study 
 
Variables are reflected on the Case Report Form 

  
 
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5.5. Participation centres 
 
Sites recruitment is still ongoing. 
 
 
5.6. Sample size 
 
 All of the patients over 65 years who had presented to emergency services due to acute 
medical or surgical reasons during the 7 days study period are to be included. Patients 
younger than 65 years of age will be excluded from the study. The patients who had been 
brought to emergency services after having undergone cardio pulmonary resuscitation by the 
emergency medical team will be also excluded from the study.  
 We strive for at least 25 patients per site per study period with a complete case report form 
(CRF). (This number is based on our pilot study, TEDGeS - Turkish Emergency Departments 
Geriatric Scoring Study) 
 Each participating center will have to enroll all consecutive cases. 
 
5.7 Study period 
 
7 consecutive days from 8:00 AM to 8:00  AM  
 
6. TREATMENT 
 
No modification on the selected management is required. 
 
 
7. STUDY METHODOLOGY. INSTRUMENTS AND PROCEDURES 
 
7.1. Recruitment methodology. 
Consecutive geriatric patient presenting to the ED during the selected study periods. 
 
7.2. Instruments 
 
Case report form (CRF): Appendix 1  
 

  
 
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8. ADVERS EVENTS 
 
No intervention on establish management is requiring.  
Adverse events registry and declaration is no applicable. 
  
 
9. ETHICAL ASPÈCTS 
 
9.1. Ethical committees  
 
Evaluation and acceptance of the protocol by local Ethical Committees is mandatory for each 
participating site. 
 
9.2. Inform consent 
 
Depending the local regulation, an informed consent through a document might be needed. 
 
9.3. Confidentiality 
 
No personal data is included on the database and all the CRF forms will be filled with ‘CASTOR 
EDC’ Clinical Data Management System, which enables secure data processes. Each center and 
country PI will be given a password to enter the data into CRF which will be secured and only be 
opened with the specific password or study managers’ password. 
 
 
9.4. Good practices 
 
Study should follow any local regulation related to good practices on medical research activities.  
 
10. LOGISTIC ASPECTS 
 
10.1. National Coordinator  
 
There will be one national coordinator in each participating country. 
His responsibilities are: 
 
 Select the participation centers.  
 To be a link between the sites and the European PIs 
 Participate on the final analysis and report. 
 
10.2. Case report form 
 
Appendix 1 
 

  
 
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10.3. Protocol 
 
10.3.1. Protocol modifications 
 
Any change in the protocol has to be accepted by the EGERS steering committee and approved by 
the local ethics committee. 
 
10.3.2. Changes in the protocol during the recruitment period 
 
No changes are accepted 
 
 
10.4. Data management 
 
CRF are completed anonymously with ‘CASTOR EDC’ Clinical Data Management System, local 
researchers are responsible of quality in the information collected. 
 
 
10.4.1. Data collection 
 
Promoter will provide the necessary tools (CRF) and online web access to transfer data into digital 
application to facilitated control and management and analysis. 
 
 
10.4.2. Data quality control 
 
Specific indicators are establishing to evaluated quality of the information basically % of missing 
data for each variable and % on NA data on each variable. 
 
10.4.3. Data  
 
Data bases will be collected and keep under control by the EGERS steering committee. Minimum 
time before deleting information is five years. 
 
 
10.5. Publications 
 
Any publication has to refer to the original protocol and promoter EGERS EuSEM Research 
Network. 
Any publication has to be communicated to National coordinators. 
No use or transmission of data to a third party may be made without the prior consent of the EGERS 
Steering Committee   
Each site will have access to its own data. 
Each publication project must be submitted to the EGERS Steering Committee 
 

  
 
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10.6. Data property 
 
Data control and property belong to the promoter: EuSEM 
 
 
10.7. Author Ship 
 
The EGERS Steering committee will be in charge of the coordination of all the articles that will be 
published.   
The 1st author will be the one that writes the article  
3 positions as authors will be dedicated to members of the EGERS Steering Committee  
Position as author will also be dedicated to people who actually participated in the development of 
the protocol and in the drafting of the results and also the number of patients with a complete CRF.   
 
 
11. ANALYSIS 
 
11.1. Data Analysis 
 
Patients will be classified based on their ages, emergency medicine diagnosis and early warning 
scores. 
The normality analyses of the data will be performed using the Kolmogorov-Smirnov and Shapiro-
Wilk tests. The data did not comply with normal distribution. The continuous variables will be 
expressed as the median (inter-quartile range), and the categorical variables were expressed as a 
number (percentage). The inter-group differences between the continuous variables will be evaluated 
using the Kruskal-Wallis test and the Mann-Whitney U test (with Bonferroni correction). The inter-
group differences between the categorical variables will be evaluated using the Chi-square and 
Fischer Exact tests. The predictive power of the scores for hospitalization and mortality in hospital 
will be evaluated using the Receiver Operating Characteristic (ROC) analysis. The values of the 
Areas Under the ROC Curve (AUC) will be evaluated. The optimum cut-off points of the scores will 
be determined for both of the main endpoints using the Youden index (sensitivity+specificity-1). 

  
 
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Using these determined cut off points for the sensitivity, specificity, positive predictive value, 
negative predictive value, likelihood ratio (+) and likelihood ratio (-), the values of both the scores 
will be calculated for both hospitalization and mortality at the hospital. Graph representation will be 
used to increase understanding of data. 
 
 
11.2. Missing data 
 
Certain crucial variables are needed to accept a CRF as a useful one. 
 
 
11.3.1. Sample size 
 
As this is a descriptive study, a formal sample size calculation has not been performed.  
  
Based on our past experience of similar studies, we would expect to enroll between 40 and 50 sites each 
with an average number of patients of at least 25/site per 7 days study period. 
 
 

  
 
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Appendix 1: Case Report Form 
EGERS CRF 
European Geriatric Emergency Departments Registry Study 
 
Inclusion criteria:    All consecutive patients aged 65 or older presenting to the Emergency  
 
Proposed study period, 7 consecutive days from 19th October 2020 to 16th November 2020:  
………………………..  (period in which recruitment was performed) 
 
 
 
First 3 Letters of the Country |__|__|__|   Site |__|__| Patient N |__|__|__|  
 
Day of admission: 
 Monday 
 Tuesday 
 Wednesday 
 Thursday 
 Fiday 
 Saturday 
 Sunday 
 
Time of admission:     
 00:00-08 00     
 08:01-16 00    
 16:01-20 00     
 20:01-23 59        
      
Gender:       
   M      
  F     Age (yo) |__|__|__|    
 
 
 
 
 
 
 
 
 
 
 
 

  
 
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Major Presenting Complaint: (Just Check One Major Complaint) 
Non-Traumatic Complaint 
 
Abdominal Pain 
 
Agitation and Psychosis 
 
The Alcoholic Patient 
 
Back Pain 
 
Bleeding 
 
Chest Pain 
 
Dizziness (Vertigo) 
 
Extremity Pain and Numbness 
 
Fever (Elevated Temperature) 
 
Headache 
 
Hypotension 
 
Jaundice 
 
Mental Status Change and Coma 
 
Palpitations and Tachycardia 
 
Rash 
 
Seizure 
 
Shortness of Breath 
 
Syncope and Near-Syncope 
 
Toxic Ingestion 
 
Change in Vision 
 
Weakness and Fatigue  
 
Abnormal findings on examination 
of blood (Hyperglycemia, Anemia, 
etc)  
 
Other Non 
trauma…………………………………………………..
………………………………………………………………
…………………………………………………… 
Traumatic Complaint 
 
Falls 
 
Motor Vehicle Accidents 
 
Pedestrian Struck 
 
Burns 
 
Assaults 
 
Other 
Trauma……………………………………………………………
…………………………………………………………………………
…………………………………………………………………………
…………………………………………………………………………
………………………………………………………………………… 

  
 
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Presentation Symptoms and Signs: 
Systolic Blood Pressure:   |__|__|__| mmHg    
Temperature: |__|__|.|__| ° C       
Diastolic Blood Pressure:  |__|__|__| mmHg    
Respiratory rate/min: |__|__|        
Heart Rate: |__|__|__| bpm   
Oxygen saturation (SpO2):  |__|__|__| %     
Needs additional oxygen supply with nasal cannula or 
face mask:   O Yes         O No   
Glasgow Coma Score: Eye:|__| Voice:|__|   Motor: |__| TOTAL: |__||__| 
Co-morbidities: 
 Coronary artery disease  
 Left Ventricular Failure 
 Right Ventricular Failure 
 Prior coronary revascularization (Bypass) 
 Chronic Obst. Pulm. Disease 
 Asthma  
 Chronic renal disease wo routine dialysis 
 Chronic renal disease with routine dialysis 
 Prior stroke (Hemorrhagic or Ischemic) 
 Diabetes mellitus  
 Hypertension  
 Dyslipidemia Chronic  
 Liver disease 
 Chronic inflammatory disease   
 Active/recent malignant tumor  
 Anemia  
 Dementia, Alzheimer  
 Immunosuppression/AIDS 
 Alcohol (> 30g/day for M and > 20 g/day for F)  
 Smoking (Active or stopped within last year)   
 Other.............................................................................
...................................................................................... 
Chronic Medications: 
 Beta-blockers   
 Calcium antagonists 
 ACE Inhibitors or Angiotensin II receptor 
blockers 
 Diuretics 
 Statins   
 Antiplatelet   
 NSAID or Other Analgesics  
 Inhaled Beta2mimetics 
 Inhaled steroids  
 Oxygen +/- NIV at home   
 Oral Antidiabetics 
 Insulin  
 Oral Steroids 
 Cardiac Glycosides   
 Vit K antagonists   
 Psychiatric treatment  
 Antidepressant 
 Antiepileptic 
 Chemotherapy Drugs  
 Other..............................................................................
...................................................................................... 

  
 
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Consequence of ED Presentation: 
Final (Hospital or ED for discharged patients) Principal Diagnosis (only one diagnosis): 
………………………..………………………………………….………………………..………………………………
………….………………………..………………………………………….………………………..………………… 
 Patient Has Home Care Service      
O Yes         O No   
     Patient Has History of Falls      
O Yes         O No   
 Patient Has Temporary Disorientation 
O Yes         O No   
  
 Discharged From the Emergency Department     
Length of stay in ED:  |__|__|__|  (hours)  
 Admission to the Emergency Observation unit  
Length of stay in Obser. Unit:  |__|__|__|  (hours)  
 Admitted to Wards 
O Cardiology      O Pneumology      
     O Internal Medicine      O Geriatrics   
O General Surgery      O Neurosurgery  
O Orthopedics/Traumatology 
O Thorax Surgery    O Cardiovascular Surgery      
 O Other …………………………….. 
 Admitted to Intensive Care Unit 
 Death at ED  
 Death during Hospitalization  
 
For HOSPİTALİZED PATİENTS 
STATUS at 30 days:   
 
30 days:   O Alive           O Death  
 
If Admitted to Wards or ICU 
 Total Length of Stay in Hospital: |__|__| (days)  
 Total Length of Stay in Wards: |__|__| (days) 
 Total Length of Stay in ICU: |__|__| (days) 
 Still in Wards 
 Still in ICU 
 
 
 

  
 
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Appendix 2                                                
Country questionnaire  
 
Number of ED proposed  
 
Emergency Department Questionnaire 
 
Institution: 
 
 
 
 
 
Address: 
 
Local PI:   
Last name:                                         First name:                   
 
Phone: 
 
e-mail address: 
 
How many patients per year do you receive in your Emergency Department (ED) __________ 
 
How many patients per year do you hospitalize either in you hospital or in another hospital: 
________________ 
 
Total number of patients presented to your ED during the study week __________ 
 
Population served (habitants) by your ED _____________  
 
Is your ED located in a:  (check ONLY ONE BOX) 
Teaching hospital: 
  
 
General hospital: 
   
 
How many full time medical staff members do you have in your ED: ________  
 
How many full time nurse staff members do you have in your ED:  _________  
 
Do you have an observation unit in your ED? 
 Yes 
   
No 
     
 
Are patients admitted to the ED observation unit considered as hospitalized? Yes 
  No 
      
 
Who perform the triage:  
Nurse 
   
Physician 
 
 
 

  
 
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COMMITMENT TO CONFIDENTIALITY OF DATA 
 
 
Dr./ Hospital 
 
It is noted: 
 
• To be undertaken the study entitled: "EGERS (European Geriatric Emergency Departments 
Registry Study)." by reviewing data from medical records, under the trial approved by the 
ethical Committee of research clinic of the Hospital 
• Who undertakes to keep strict confidentiality of personal data from the source. 
• Test results may be reported in congresses, meetings and scientific publications always 
safeguarding the confidentiality of personal data. 
 
 
 
 
 
Signature:    Dr.   …………………………………… 
 
…………………………………… 
 
……………………………………   
 
…………………………………… 
 
……………………………………   
 
 
 
 
 
 
In        COUNTRY                   ,       DATE  
 
 
 
 
 
 
 
 
 
 

  
 
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PARTICIPANT INFORMED CONSENT PAPER 
 
Research Project Title: EGERS (European Geriatric Emergency Departments Registry Study) 
Promoter: Dr./Dr. 
I (name and surname of the patient or family member by specifying the degree)...  
I have read the information sheet that it has given me.  
I could do the study questions.  
I have received sufficient information on the study.  
I have spoken to: Dr/Dr. (name of the researcher)   
I understand that my participation is voluntary.  
I understand that I may withdraw my study: 
1. Whenever  
2. Without having to give explanations.  
3. Without that this impact on my health care.  
I freely provide my agreement to participate in the study.   
 
 
 
SIGNATURE of participant: ……………………………..  
 
 
SIGNATURE of RESEARCHER   Dr.  ……………………………….. 
 
 
 
 
 
…………………………………… 
 
 
 
 
 
……………………………………   
 
 
 
 
 
…………………………………… 
 
 
 
 
 
……………………………………   
 
 
 
DATE: …………………………………… 
 
 
 
 
 
  
 
 
 
 
 
 
 
 

  
 
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INFORMATION SHEET TO THE PATIENT  
 
The Study Title: EGERS (European Geriatric Emergency Departments Registry Study)  
Promoter: Main RESEARCHER Mehmet Akif KARAMERCAN MD PhD, Chair of the 
Geriatrics Special Interest Group of EuSEM Research Committee 
 
INTRODUCTION  
We are writing to inform you about a research study in which you are invited to participate. 
The study has been approved by the Committee of ethics of the research of the Hospital….., 
according to the legislation in force, and is carried out with respect for the principles 
contained in the Helsinki Declaration and the standards of good clinical practice.  Our 
intention is just that you are receiving the correct information and sufficient so that you can 
evaluate and judge whether you want to or not to participate in this study. So read this fact 
sheet with attention and we will clarify any doubts that might arise after the explanation. 
In addition, you can consult with persons it deems appropriate.  
 
VOLUNTARY PARTICIPATION: you should know that your participation in this study is 
voluntary and you can decide not to participate or change its decision and withdraw consent at 
any time, without therefore will alter the relationship with your doctor or causing prejudice in 
its treatment.  
 
 
GENERAL DESCRIPTION OF THE STUDY:  
The main objective of this project will be  
o To determine Epidemiologic and Age Related Characteristics of Geriatric Patients 
presenting to the ED across Europe. 
 
o To evaluate Early Warning Scoring systems and determine most suitable Geriatric 
Emergency Medicine Risk Score 
 
DESIGN OF THE STUDY: 
It is a prospective, observational, longitudinal, multicenter, multi-continental study. The 
estimated duration of study is three (3) months, will be carried out by the emergency room 
doctors of the emergency service of.... It does not involve risks for the patient. 
 
Thanks to your cooperation in the present study, the population of the European Union, will 
benefit and therefore it may save lives, which would not be possible without their 
collaboration, and this study. There is no problem in the participation of women in fertile age. 
The treatment that will receive is not going to be changed by its involvement in the study. The 
doctor responsible for the study (Dr/Dra), can provide you more information, if desired. 

  
 
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Treatment, communication and the transfer of personal data of all participating subjects shall 
comply with provisions in the organic law ………………..of protection of data of a personal 
nature, and its development regulations. According to the provisions of the above-mentioned 
legislation, you can exercise the rights of access, modification, opposition and cancellation of 
data, for which should be addressed to your physician study. 
 
 
Data collected for the study will be identified by a code and only your doctor's study and 
collaborators can relate this data with you and your medical history. Therefore, your identity 
will not be disclosed to any other person. 
 
COMPENSATION: your participation in the study does not imply you any expenses. 
  
OTHER RELEVANT INFORMATION: if you decide to withdraw the consent to 
participate in this study, no new data will be added to the database, and it may require the 
destruction of all identifiable samples previously retained to prevent the implementation of 
new analysis, while those responsible for the study may continue to use information collected 
about you until then, unless you expressly object. If you is removed from the study, by some 
of the expressed reasons, your doctor will prescribe a treatment appropriate to his illness.  
By signing the attached consent sheet, undertakes to comply with the procedures of the study 
explained him. 
 
 
Dr.  
 
 
 
                                                  In         
COUNTRY,      
 
DATE