GeriNOT in the Surgical Inpatient Setting

Area of Science:

• Geriatric Medicine
• Health Services Research
• Health Informatics

Background:

• The German Federal Joint Committee (G-BA) mandates validated geriatric screening tools for hip fracture patients.
• Integrating the GeriNOT tool into hospital information systems (KIS) allows for process-generated data collection during acute admission.
• This study investigates if GeriNOT can identify risks in other geriatric diagnostic groups beyond hip fractures.

Purpose of the Study:

• To evaluate the predictive power and classification accuracy of the GeriNOT tool for identifying geriatric risks in patients aged 70 and above.
• To assess the tool's effectiveness across different diagnostic groups, including overall acute admissions, fractures, hip fractures, and spinal conditions.
• To determine if early risk identification using GeriNOT can predict the need for post-acute care and new admissions to long-term care facilities.

Main Methods:

• Retrospective, bicentric analysis of electronic health records from May 2014 to April 2015 (n=3443).
• Focus on a subgroup of acute orthopedic/trauma admissions (n=821) to analyze outcomes related to post-acute care utilization and long-term care placement.
• GeriNOT prediction and classification accuracy were assessed for defined endpoints in various diagnostic groups.

Main Results:

• All analyzed diagnostic groups (overall admissions, fractures, hip fractures, spinal conditions) showed elevated mean GeriNOT scores above the threshold (≥4).
• The hip fracture group had the highest mean GeriNOT score (4.85), while spinal fractures had the lowest (4.18).
• Despite identified risks, only 4.26% of at-risk patients received acute geriatric care; however, GeriNOT detected increased risk for post-acute care needs, particularly in the hip fracture group (31.48% admissions from care).

Conclusions:

• The GeriNOT tool, when integrated into KIS for acute admission management, systematically identifies geriatric risks across diverse patient groups, notably spinal conditions.
• The study highlights a significant geriatric risk in all analyzed groups, underscoring the need for early intervention.
• KIS-supported GeriNOT implementation can serve as a foundation for risk-adjusted treatment pathways, potentially improving patient outcomes.