Key result
The Flemish version of the Triage Risk Screening Tool had a low discriminative value for identifying older cardiology patients at risk for inhospital functional decline (AUC 0.60, specificity 23.8%).
Why the study?
It was unknown whether routine screening with the Flemish version of the Triage Risk Screening Tool (fTRST) is a valid approach to identify cardiac care ward patients at risk for inhospital functional decline who would benefit from geriatric expertise consultation.
Does routine screening with the fTRST accurately identify older adults on cardiac care wards at risk for inhospital functional decline?
Cohort (n=189)
No
Does routine screening with the fTRST accurately identify older adults on cardiac care wards at risk for inhospital functional decline?
Effect estimate: AUC 0.60
The fTRST has low discriminative value for identifying older cardiology patients at risk for functional decline, suggesting a need for universal needs assessment upon admission rather than targeted screening.
Objective To determine whether routine screening with the Flemish version of the Triage Risk Screening Tool (fTRST) is a valid approach to determine which patients on cardiac care wards are at risk for inhospital functional decline and would benefit from geriatric expertise consultation.Methods A secondary data-analysis of the G-COACH before-cohort, describing patient profiles and routine care processes, in 189 older adults on two cardiac care wards in the University Hospitals Leuven between September 2016 and June 2017. Inhospital functional decline was defined as an increase of at least one point on the Katz Index of Activities of Daily Living or death between hospital admission and discharge.Results Nine in 10 patients had at least one geriatric syndrome and one-third developed functional decline. Based on the fTRST proposed cut-off of ≥2, 156 (82.5%) patients were at risk for functional decline (sensitivity of 95.2%, specificity of 23.8%, negative predictive value of 90.9% and Area Under the Curve of 0.60). Of the 156 ‘at risk’ patients, 43 (27.6%) received a consultation by the geriatric consultation team after a median of four hospitalization days. A positive fTRST was not significantly related to geriatric consultations (x2 = 0.57; p = 0.45).Conclusion The fTRST has a low discriminative value in identifying older cardiology patients at risk for functional decline. Given the high prevalence of geriatric syndromes, we propose a new paradigm were all older adults on cardiac care wards undergo a needs assessment upon hospital admission.
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Jeuris et al. (2022) conducted a cohort in Inhospital functional decline in cardiac care wards (n=189). Flemish version of the Triage Risk Screening Tool (fTRST) was evaluated on Inhospital functional decline (increase of at least one point on the Katz Index of Activities of Daily Living or death) (AUC 0.60). The Flemish version of the Triage Risk Screening Tool had a low discriminative value for identifying older cardiology patients at risk for inhospital functional decline (AUC 0.60, specificity 23.8%).
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