Older Emergency Department Users and Short-term Adverse Events at the Index Visit

Study Overview
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Brief Summary
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This study evaluates the difference between PRISMA-7 and ER2 tool. There are some differences between PRISMA-7 and ER2 tool. The differences consist in evaluation criteria that are used to perform the both surveys. We suppose that evaluation criteria of PRISMA-7 is not accurately enough to calculate the length of hospital stay and to predict the short-term outcomes.

Detailed Description
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The Program of Research on Integration of Services for the Maintenance of Autonomy (PRISMA-7) is the Ministry of Health and Social Services' reference tool for the assessment of older ED users in Quebec (Canada). PRISMA-7 has been initially designed to screen disability in community-dwelling older adults and has never been validated for risk for short-term adverse events in older ED users. Emergency room evaluation and recommendations (ER2) is another clinical tool which is currently evaluated in Quebec. Compared to PRISMA-7, ER2 has been especially designed for assessing risk for short-term ED adverse events. No study has compared PRISMA-7 and ER2 risk for short-term adverse events. We hypothesised that ER2 could be a better prognostic tool compared to PRISMA-7 for long length of stay in ED and hospital stay, and hospital admission because it was designed and validated for this specific goal. The study aims to 1) examine and compared PRISMA-7 and ER2 risk for long length of ED and hospital stay and hospital admission, and 2) to establish their performance criteria (i.e., sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratios) for these three short-term adverse events in older ED users.

Official Title
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Older Emergency Department Users and Short-term Adverse Events at the Index Visit: Which Clinical Prognostic Tool is Used?

Conditions
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Health Impairment, Adverse Event, Hospitalization

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Being 75 years old and over Brought at Emergency on medical stretcher Exclusion Criteria: Being less than 75 years old Never come at Emergency

Ages Eligible for Study
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Minimum Age: 75 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Observational<br>Each participant will be evaluated at Emergency Department based on ER2 screening tool (Emergency Room Evaluation and Recommendation Form). Six closed-ended format questions (i.e., yes versus no) composed ER2 assessment: Age category (≥ 85), male, polypharmacy (≥ 5 different medications per day), use of formal (health care or social professional) and/or informal (family and/or friend) home support, use of a walking aid regardless its type, and temporal disorientation (inability to give the current month and/or year). | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Short-term adverse events | The adverse event is defined as an adverse outcome related to an ED encounter, this adverse event is related to ED care. | Around 10 months |