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Predictive validity of the triage risk screening tool for elderly patients in a Canadian emergency department
Jerome Fan1, Andrew Worster, Christopher M B Fernandes
1Department of Emergency Medicine, McMaster University, Hamilton, Ontario, Canada L8N 3Z5.
Purpose:
We sought to externally evaluate the predictive validity of the Triage Risk Screening Tool (TRST) for elderly patients in a Canadian setting.
Methods:
A prospective, observational cohort study of a convenience sample of patients more than 64 years old was assessed using the TRST before discharge. The composite outcome of any emergency department (ED) revisit, hospital admission, or long-term care placement at 30 and 120 days was measured. Likelihood ratios (LRs) and 95% confidence intervals (CIs) were calculated.
Main Findings:
Of 218 patients screened, 120 patients were enrolled. At 30 and 120 days, the positive LRs were 1.4 (95% CI, 0.9-2.0) and 1.4 (95% CI, 1.0-1.9), respectively. The negative LRs were 0.7 (95% CI, 0.4-1.3) and 0.7 (95% CI, 0.4-1.0), respectively.
Conclusion:
The TRST cannot be used as a single diagnostic test to predict whether Canadian ED elders will have an ED revisit, hospital admission, or long-term care placement at 30 or 120 days.