Prediction of adverse health outcomes in older patients visiting the Emergency Department: the APOP study

Author(s):
Gelder, J. de
Published
2019
Publication type
Doctoral Thesis

Abstract

The rate of adverse health outcomes 90 days after an emergency department (ED) visit is high for older patients.A comprehensive geriatric assessment (CGA) can effectively identify patients at highest risk and improve outcomes. Unfortunately, the fast-paced environment and the medical condition of the acutely ill older patient make it virtually impossible to perform a CGA in all patients in the ED. Therefore, it was the aim of the present thesis to develop a screening instrument for the ED setting to identify older patients at high risk for adverse health outcomes, in order to target them for future interventions to preserve their independency and quality of life. In a multicenter prospective cohort study a total of 2629 older ED patients were included with a mean age of 79 years old. After 90 days 805 patients (30.6%) experienced functional decline or mortality. A new screeninginstrument to identify older ED patients at risk for adverse health outcomes was developed and validated: the APOP screener. The APOP screener adequately identifies older ED patients at highest risk for functional decline or mortality and is promising for clinical use.

Older patientsFunctional declineMortalityEmergency DepartmentScreening instrumentGeriatricsAPOP-screenerFrailty
Defense date
2019-10-17
Language
English
Supervisor(s)
Blauw, G.J.
Advisor(s)
Mooijaart, S.P.; Groot, B. de
Committee member(s)
Dekkers, O.M.; Buurman, B.M.; Carpenter, C.R.
Qualification
Ph.D.
Degree granting institution
Interne geneeskunde - ouderengeneeskunde, Medicine / Leiden University Medical Center (LUMC), Leiden
hdl
1887/79262
ISBN(s)
9789463805131

Funding

Sponsorship
ZonMw