Recent admissions are a risk indicator for returning emergency room (ER) visits and readmissions: screening using...

Emergency rooms (ER) are frequently the gateway for older adults seeking acute medical care. The Identification of Seniors at Risk (ISAR) tool is a brief screening instrument intended to identify older people at risk for adverse health outcomes. However, its predictive value for short-term hospital returns remains unclear. We aimed to determine the predictive value of the ISAR questionnaire for ultra-short-term adverse outcomes, namely 3-day ER revisits and 3-day readmissions, in older adults in Taiwan.

This prospective study included patients aged ≥65 years who visited the ER of a community hospital in Taiwan in 2021 and 2022. ISAR screening was performed by trained nurses. The outcome variables were 3-day ER revisits and 3-day readmissions. The main predictor variables included total ISAR score (≧2vs.≦1) and individual ISAR items. Covariates included age, gender, triage level, arrival method, pain score, observation time and disease category.

Of 9697 eligible patients, 3039 (31.3%) underwent ISAR screening. ISAR-screened patients had a higher rate of both 3-day ER revisits and readmission (6.2% vs. 4.7%, p < 0.001; 1.7% vs. 0.9%, p = 0.001). Of the individual ISAR questions, the item "recent hospitalization within 6 months" was significantly associated with both 3-day ER revisits and readmission (OR = 1.852 and OR = 2.290), respectively. The accuracy was 88.1% and 91.6%, respectively.

The single item "recent hospitalization within 6 months" can be an independent risk indicator. Emergency triage should prioritize this specific question for short-term risk stratification.