Screening for frailty among older emergency department visitors: Validation of the new FRESH-screening instrument.
Screening for frailty among older emergency department visitors: Validation of the new FRESH-screening instrument.
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DOI：
10.1186/s12873-016-0087-0
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发表时间：
2016-07-22
影响因子：
2.5
通讯作者：
Synneve ID
中科院分区：
文献类型：
--
作者：
Kajsa E;Katarina W;Sten L;Synneve ID
在不同的医疗保健机构中识别体弱老年人被广泛认为是改善医疗保健系统的重要一步。在急诊科（艾德）进行的筛查应在几分钟内完成，无需进行检测或测量。FRESH筛选是为此目的而开发的。本研究的目的是评估FRESH筛查及其结构效度，并评估其敏感性、特异性和预测值。本研究采用横断面设计。共有161名在Mölndal医院急诊科寻求护理的老年人被纳入其中。入选标准为年龄≥80岁或年龄65-79岁，至少有一种慢性疾病，并且至少有一种日常生活活动依赖。敏感性，特异性和预测值进行了计算，以描述FRESH筛选的准确性，在确定那些与脆弱，评估了8个脆弱的指标。灵敏度和特异性均设定为最低80%，灵敏度和阳性预测的百分比总和≥150被认为是极好值的度量。当将FRESH筛查的四个问题与八个虚弱指标进行比较时，灵敏度和特异性都很高（分别为81%和80%）。灵敏度和阳性预测的百分比总和为173（81% ± 92%），因此超过150截止值。这项研究表明，FRESH筛查具有很好的临床价值。此外，临床经验表明，该仪器使用简单快速，只需几分钟即可使用，老年人只需输入最少的能量。
The identification of frail older persons in different health care settings is widely seen as an important step in improving the healthcare system. Screening at an emergency department (ED) should be handled in just a few minutes without the use of tests or measurements. The FRESH-screening was developed for this purpose. This study’s aim was to evaluate the FRESH-screening and its construct validity; also assessed were the sensitivity, specificity, and predictive values for frailty screening. The study had a cross-sectional design. A total of 161 elderly people who sought care at the emergency department at Mölndal Hospital were included. Inclusion criteria were ages ≥80 years or ages 65–79 with at least one chronic disease and dependence in at least one daily living activity. Sensitivity, specificity, and predictive values were calculated to describe the accuracy of the FRESH-screening in identifying those with frailty, as assessed by eight frailty indicators. Sensitivity and specificity were both set at a minimum of 80 %, and a percentage sum ≥150 of the sensitivity and positive prediction was considered a measure of excellent value. Both sensitivity and specificity were high (81 % and 80 %, respectively) when comparing the four questions of the FRESH-screening against the eight frailty indicators. The percentage sum of sensitivity and positive prediction was 173 (81 % + 92 %), thus exceeding the 150 cutoff. This study shows the FRESH-screening to be of excellent clinical value. Additionally, the clinical experience is that the instrument is simple and rapid to use, takes only a few minutes to administer, and requires minimal energy input by older persons.