[The ISAR-positive patient in urology]

Area of Science:

• Geriatric Medicine
• Urology
• Healthcare Management

Background:

• Mandatory ISAR Screening (Identification of Seniors at Risk) for patients over 75 in German hospitals since 2015.
• Unclear characterization and clinical application of geriatric assessments for identified patients in urology.
• Need to understand the integration of ISAR screening into urological care pathways.

Purpose of the Study:

• To investigate the characterization of elderly patients identified by ISAR screening in urology.
• To assess the application of geriatric assessment data in the clinical treatment of these patients.
• To evaluate the correlation between ISAR status and specific geriatric risks and urological conditions.

Main Methods:

• Study period: July 1st to December 31st, 2016.
• 337 patients over 75 years underwent ISAR screening.
• ISAR results were compared with assessments of fall risk, pressure ulcer risk, malnutrition, demographics, and urological diagnoses.

Main Results:

• 102 patients (27.05%) were ISAR-positive, significantly older than ISAR-negative patients.
• ISAR-positive patients exhibited higher risks of falls, pressure ulcers, and malnutrition.
• ISAR-positive patients had more diagnoses, predominantly oncological and infectious urological diseases, and were more frequently admitted as emergencies.
• While most patients underwent ISAR screening, subsequent assessments were less consistently performed.

Conclusions:

• ISAR screening effectively identifies vulnerable, multimorbid elderly patients in urology facing risks like chronification and loss of autonomy.
• Consistent implementation of ISAR screening and subsequent assessments into routine urological care remains a significant challenge.
• Systemic integration is key to improving care for high-risk geriatric patients in urology.