A novel validated prognostic index for older patients in the emergency department: gazi index

Several indices are available to predict poor outcomes in older patients admitted to the emergency department (ED); however, there remains a need for more practical, sensitive, and easily applicable tools. This study aimed to develop a novel prognostic index to predict the risk of disability, hospitalization, and mortality in older patients presenting to the ED.

This study included 356 patients aged 65 and older presenting to the ED. Exclusion criteria were: poor general condition preventing response to questions, low level of consciousness (GCS <15), inability to provide informed consent, and lack of prospective follow-up. The G8 scale, PRISMA-7 questionnaire, Katz Activities of Daily Living Questionnaire (ADL) scale, and Charlson Comorbidity Index were administered. Follow-up assessments were conducted via telephone on the 30th and 180th days post-application, using the Katz ADL scale. Patients or their relatives were also queried about repeated outpatient clinic visits, emergency admissions, hospitalizations, nursing home admissions, and survival status.

Parameters significantly associated with adverse outcomes in univariate analysis were further analyzed using multivariate regression, resulting in the development of the GAZI Index. This new index includes six simple parameters independently associated with adverse outcomes. The predictive performance of the GAZI Index was compared to that of the PRISMA-7, a validated tool in the ED. The GAZI Index demonstrated significantly superior predictive ability for poor outcomes compared to the PRISMA-7 (p = 0.008).

The GAZI Index is a novel, valid, and practical tool for predicting adverse outcomes in older patients presenting to the ED.