External validation of geriatric influenza death score: A multicenter study

Area of Science:

• Geriatric Medicine
• Infectious Diseases
• Emergency Medicine

Background:

• The Geriatric Influenza Death (GID) score aids decision-making for older adults with influenza in the emergency department (ED).
• External validation data for the GID score was previously unavailable, creating a knowledge gap.

Purpose of the Study:

• To externally validate the Geriatric Influenza Death (GID) score in a large cohort of older patients presenting with influenza to the ED.
• To assess the discrimination, goodness of fit, and predictive performance of the GID score.

Main Methods:

• Retrospective collection of demographic and clinical data from 5,508 older patients (≥65 years) with influenza across three hospitals (2009-2018).
• Evaluation of the GID score's discrimination using the area under the curve (AUC) and goodness of fit via the Hosmer-Lemeshow test.
• Analysis of mortality odds ratios associated with different GID score levels.

Main Results:

• The GID score was significantly higher in patients who died (1.7±1.1 vs. 0.8±0.8, p <0.01).
• The area under the curve was 0.722 (95% CI: 0.677-0.766), indicating good discrimination.
• The GID score demonstrated excellent negative predictive values and good external validity, with odds ratios for mortality increasing substantially with higher scores.

Conclusions:

• The Geriatric Influenza Death (GID) score shows good external validity and performance in predicting influenza-related mortality in older emergency department patients.
• The GID score can be a valuable tool for clinical decision-making in this population.
• Further research is recommended to support broader application of the GID score.