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

Tom Knauf; Benjamin Buecking; Lukas Geiger; Juliana Hack; Ruth Schwenzfeur; Matthias Knobe; Daphne Eschbach; Steffen Ruchholtz; Rene Aigner; Registry for Geriatric Trauma DGU

doi:10.2147/CIA.S344689

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

Clin Interv Aging. 2022 Mar 31:17:309-316. doi: 10.2147/CIA.S344689. eCollection 2022.

Authors

Tom Knauf¹, Benjamin Buecking², Lukas Geiger¹, Juliana Hack¹, Ruth Schwenzfeur³, Matthias Knobe⁴, Daphne Eschbach¹, Steffen Ruchholtz¹, Rene Aigner¹; Registry for Geriatric Trauma DGU

Affiliations

¹ Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany.
² Department for Trauma Surgery, Klinikum Hochsauerland, Arnsberg, Germany.
³ Working Committee on Geriatric Trauma Registry of the German Trauma Society (DGU), München, Germany.
⁴ Department of Orthopaedic and Trauma Surgery, Cantonal Hospital Lucerne, Lucerne, Switzerland.

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; geriatric patient; hip fracture; identification of seniors at risk.

MeSH terms

Aged
Aged, 80 and over
Geriatric Assessment
Hip Fractures* / surgery
Humans
Length of Stay
Patient Discharge*
Risk Factors