Validation of the acutely presenting older patients tool in a real world setting: results from a large clinical hospital in the Netherlands

INTRODUCTION: The number of older patients visiting the emergency department (ED) is increasing. The Acutely Presenting Older Patients (APOP) screener has been developed to identify older patients at highest risk of mortality or functional decline after the hospital visit. In this study we aim to assess association between the APOP score and mortality for older patients presenting in the ED at the Maasstad hospital using real world data. METHODS: Within this retrospective cohort study, all patients aged 70 years and older, who visited the ED of the Maasstad Hospital in 2021 were included. The use of the APOP screener is standard practice at the ED of the Maasstad Hospital. Patients who were triaged red with the Manchester Triage System were excluded from the analyses. RESULTS: 6136 patients of 70 years and older were included at the ED of the Maasstad Hospital. 70.9 % of these patients had a filled APOP screener. Of those patients, 663 died (15.2 %). Mortality rate was lower in patients with a negative APOP screener than in patients with a positive APOP screener (9.7 % vs 25.6 %), with an odds ratio of 2.08 (CI95% 1.88-2.30). CONCLUSION: This study shows that the APOP screener, when used in the real word, has a fairly high association with three month mortality, even when adjusting for other variables that could indicate frailty. Furthermore the fill-in rate, in the real world, is high which shows that its implementation in a large teaching hospital is feasible.