Comprehensive geriatric assessment in the emergency department: A protocol for a prospective cohort study

Íde O'Shaughnessy, Katie Robinson, Margaret O'Connor, Mairéad Conneely, Fiona Steed, Damien Ryan, Leonora Carey, Denys Shchetkovsky, Elaine Shanahan, Aoife Leahy, Colin Quinn, Ali Sheikhi, Rose Galvin, Íde O'Shaughnessy, Katie Robinson, Margaret O'Connor, Mairéad Conneely, Fiona Steed, Damien Ryan, Leonora Carey, Denys Shchetkovsky, Elaine Shanahan, Aoife Leahy, Colin Quinn, Ali Sheikhi, Rose Galvin

Abstract

Background: Comprehensive geriatric assessment (CGA) has been shown to improve outcomes in hospitalised older adults; however, there is currently no compelling evidence to support CGA interventions within the Emergency Department (ED). The aim of this study is to explore the clinical and process outcomes of older adults who receive ED-CGA over a period of six months after their initial ED attendance. Design: Prospective cohort study. Methods: The STrengthening the Reporting of the OBservational studies in Epidemiology (STROBE) standardised reporting guidelines will be adhered to. Older adults aged ≥65 years who score ≥2 on the Identification of Seniors at Risk (ISAR) tool and present to the ED with a medical complaint during the operational hours of the dedicated interdisciplinary team, will be considered eligible for recruitment. Demographic and health assessment information will be obtained at the ED index attendance followed by completion of an interdisciplinary CGA. A dedicated research nurse will complete follow-up telephone interviews with participants at 30 days and six months. The primary outcome will be incidence of hospital admission from the ED index attendance. Secondary outcomes will include functional decline, patient satisfaction with the ED index attendance, unscheduled ED reattendance(s), unscheduled hospital (re)admission(s), nursing home admission(s), healthcare utilisation, and death. Descriptive statistics will be used to profile the characteristics of the study participants and multivariate logistic and linear regression analysis will be used to analyse risk of adverse outcomes. Ethics and dissemination: Ethical approval was granted by the University of Limerick Hospital Group Research Ethics Committee (107/2021). The authors will disseminate study findings through publication in a peer-reviewed journal and presentation at national and international conferences. Patient and public involvement will be sought from a panel of older adults at the Ageing Research Centre in the University of Limerick. Clinicaltrials.gov Identifier: NCT05252182.

Keywords: Cohort Study; Comprehensive Geriatric Assessment; Emergency Department; Frailty; Older Adults.

Conflict of interest statement

No competing interests were disclosed.

Copyright: © 2022 O'Shaughnessy Í et al.

References

    1. Md State Med J. 1965 Feb;14:61-5
    1. J Am Med Dir Assoc. 2016 Dec 1;17(12):1163.e1-1163.e17
    1. CMAJ. 2005 Aug 30;173(5):489-95
    1. Cochrane Database Syst Rev. 2017 Sep 12;9:CD006211
    1. J Am Geriatr Soc. 1999 Oct;47(10):1229-37
    1. Intern Emerg Med. 2007 Dec;2(4):292-301
    1. J Am Geriatr Soc. 1991 Sep;39(9 Pt 2):8S-16S; discussion 17S-18S
    1. Ann Emerg Med. 2017 Apr;69(4):426-433
    1. Arch Gerontol Geriatr. 2016 Jan-Feb;62:97-102
    1. J Clin Epidemiol. 1994 Nov;47(11):1245-51
    1. HRB Open Res. 2020 Jan 14;3:1
    1. Lancet. 2013 Mar 2;381(9868):752-62
    1. Can Geriatr J. 2016 Mar 31;19(1):9-14
    1. Age Ageing. 2015 Sep;44(5):761-70
    1. Age Ageing. 2011 Jul;40(4):436-43
    1. Age Ageing. 2020 Oct 23;49(6):936-938
    1. Ann Intern Med. 2007 Oct 16;147(8):573-7
    1. Age Ageing. 2016 Sep;45(5):577-84
    1. PLoS One. 2019 Jul 31;14(7):e0220709
    1. Ann Med. 2001 Jul;33(5):337-43
    1. World J Emerg Med. 2018;9(1):20-25
    1. PLoS One. 2018 Aug 30;13(8):e0203316
    1. Age Ageing. 2014 Jul;43(4):496-502
    1. Age Ageing. 2016 Mar;45(2):255-61
    1. J Am Geriatr Soc. 1987 May;35(5):398-404
    1. Age Ageing. 2014 Jan;43(1):109-14

Source: PubMed

Sponsors and Collaborators

Medical Conditions

Drug Interventions

3
Subscribe