Triage Assessment and NEWS-score as Risk Predictor in Older Frailty Adults in the ED

3-level Triage Assessment and National Early Warning Score as Predictor for Mortality, Hospital Admission and ED Readmission for Older Frailty Patients in the ED

Emergency Department Triage Systems have not been shown to sufficiently recognize frail elderly patients in need of urgent assessment and care. In this prospective, observational study the performance of the 3-level triage system and the National Early Warning Score (NEWS) 2 are assessed (separately and combined) for predicting adverse outcomes in older frailty patients visiting in the ED. Observational data for this study is gathered as part of GAOPS - main study (ClinicalTrials.gov Identifier: NCT03751319).

Study Overview

• Status: Completed
• Conditions: Frailty; Aged; Triage

• Study Type: Observational
• Enrollment (Actual): 1711

Contacts and Locations

Study Locations

• Finland
  • Espoo, Finland, 02740
    • Helsinki University Central Hospital, Jorvi

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 75 years and older (Older Adult)
• Accepts Healthy Volunteers: N/A
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Residents of aforementioned counties, aged over 75 years, who attend the Emergency department and have clinical frailty scale minimum 4.

Description

Inclusion Criteria:

• "Clinical Frailty Scale" minimum 4 estimated at the arrival to the ED by nurse

Exclusion Criteria:

• Non-resident of the counties (City of Espoo, Kirkkonummi, Kauniainen) of the hospital district.

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Older Adult Patients; ED patients age of ≥ 75 who have nurse assessed Clinical Frailty Scale ≥ 4.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Mortality	Mortality during the 30 day follow-up	30 days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Hospital admission	Admission to hospital from the Emergency Department	Day 0
ICU/HDU admission	Admission to the Intensive Care Unit or High Dependency Unit from the Emergency Department	Day 0
Readmission in the ED	Re-visits to the ED after the index-visit	Hour 72, Day 30

Collaborators and Investigators

• Sponsor: Helsinki University Central Hospital
• Collaborators: University of Helsinki; City of Espoo
• Investigators: Study Director: Veli-Pekka Harjola, Department of Emergency Medicine and Services, Helsinki University Hospital; Principal Investigator: Janne Alakare, MD, Department of Emergency Medicine and Services, Helsinki University Hospital

Publications and helpful links

General Publications

• Kemp K, Alakare J, Harjola VP, Strandberg T, Tolonen J, Lehtonen L, Castren M. National Early Warning Score 2 (NEWS2) and 3-level triage scale as risk predictors in frail older adults in the emergency department. BMC Emerg Med. 2020 Oct 28;20(1):83. doi: 10.1186/s12873-020-00379-y.

Helpful Links

• Full text

Study record dates

Study Major Dates

• Study Start (Actual): December 11, 2018
• Primary Completion (Actual): September 1, 2019
• Study Completion (Actual): October 28, 2020

Study Registration Dates

• First Submitted: December 19, 2018
• First Submitted That Met QC Criteria: December 19, 2018
• First Posted (Actual): December 20, 2018

Study Record Updates

• Last Update Posted (Actual): February 1, 2022
• Last Update Submitted That Met QC Criteria: January 29, 2022
• Last Verified: January 1, 2022

More Information

Terms related to this study

• Keywords: Emergency triage
• Additional Relevant MeSH Terms: Pathologic Processes; Frailty
• Other Study ID Numbers: HUS/278/2018

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No