Abstract

Background: Older adults can suffer from adverse outcomes after emergency department (ED) visits, and there are currently no suitable screening tools in Taiwan to identify high-risk older adults in the ED.

Methods: We developed the Taiwan Seniors at Risk (TSAR) screening tool, consisting of six questions in a straightforward yes/no format. The tool demonstrates a high content validity, with a Content Validity Index of 0.93. A longitudinal study of 135 patients aged ≥ 65 years was conducted in the ED of a tertiary-care medical center in Taiwan. Data collected at baseline included demographic factors, the Taiwan Triage and Acuity Scale, medical diagnoses in the ED), the Charlson Comorbidity Index, TSAR, and the Modified Katz Index of Independence in Activities of Daily Living. Follow-up assessments at 1 month and 3months after EDvisits focused on ED revisits, institutionalization, functional decline, andmortality.

Results: TSAR had a sensitivity of 0.65 and specificity of 0.64 at 1 month after an ED visit and a sensitivity of 0.63 and specificity of 0.31 at 3 months after an ED visit. Further analysis indicated the area under the curve was 0.67, and the best cut-off point was 2.

Conclusion: Healthcare providers in ED can use the TSAR to quickly screen and it can serve to identify high-risk groups in need of targeted assessment and early intervention.