The Predictive Value of the “Identification of Seniors at Risk” Score on Mortality, Length of Stay, Mobility and the Destination of Discharge of Geriatric Hip Fracture Patients

Abstract

Purpose: The German Society for Geriatrics recommends the “ISAR” questionnaire as a screening tool for patients ≥ 70 for geriatric screening in emergency rooms. Although the ISAR-score is collected routinely in the “AltersTraumaRegister DGU ® ” (ATR-DGU), to date less is known about the predictive value of the “ISAR”-score in geriatric trauma patients. Patients and Methods: Currently, 84 clinics participate in the ATR-DGU. This evaluation is limited to the subgroup of proximal femur fractures from 2016– 2018. Patients ≥ 70 years, who underwent surgery for a hip fracture are included in the ATR-DGU. In this evaluation, the influence of the “ISAR”-score on mortality, length of stay, mobility and the destination of discharge was examined. Results: Overall 10,098 patients were included in the present study. The median age was 85 years (interquartile range (IQ) 80– 89 years). According to the ISAR-score 80.6% (n=8142) of the patients were classified as geriatric patients (cut off “ISAR”-score ≥ 2 points). These group of patients had a length of stay of 16 days (IQ10.1– 22.1) compared to the non-geriatric patient cohort showing a length of stay of 15 days (IQ10.1– 20.1). Patients showing an ISAR-score ≥ 2 had an increased risk of being discharged to a nursing home (OR 8.25), not being able to walk (OR 12.52) and higher risk of mortality (OR 3.45). Conclusion: The “ISAR”-score shows predictive power for the length of stay, mobility, hospital mortality and discharge after hospital in the collective of geriatric trauma patients. It therefore seems suitable as a screening tool for geriatric trauma patients in the emergency department and should be considered in this context. Keywords: ISAR-score, hip fracture, geriatric patient, identification of seniors at risk

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