Risk stratification tool for older emergency department patients: the 6-items brief geriatric assessment

Background Older patients are increasingly admitted to Emergency Departments (ED) and therefore, outcome prediction tools are important to provide adequate care. The study aimed to explore the value of the 6-item brief geriatric assessment (BGA) to stratify the risk for older patients for hospital admission, length of stay (LOS), or death. Methods This was an observational prospective cohort study, conducted in 36 European EDs and included 65 years and older patients with any complaint for seven consecutive days. The 6-item BGA was performed at admission and classified the population in three levels of risk (low (LR), moderate (MR) or high (HR)). Generalized linear mixed models were used to assess the association of end points and BGA risk groups. Results Among 4657 patients, 48% were men and the median age was 77 yo. The association of ward admission was similar in BGA LR and MR groups but higher in the HR group (risk ratio RR = 1.22 [95%-confidence interval (CI) 1.13–1.31]). Compared to the LR group, the hospital LOS was similar in MR but higher in the HR group with a LOS ratio at 1.31 [95%-CI 1.20–1.42]. Mortality was higher in MR and HR groups with RR = 2.02 [95%-CI 1.20–2.83] and 3.12 [95%-CI 2.47–3.77] respectively. Conclusion The study demonstrated the ability of the 6-item BGA to identify frail patients in ED older population. As an integratied parameter of existing triage systems, BGA can help to target frailer older patients. Such targeted approaches may accelerate treatment and enhance clinical outcomes. The study was registered with the U.S. National Library of Medicine Clinical Trials (trial number NCT04680299; registration date: 2020-12-22).