The Predictive Value of the “Identification of Seniors at Risk” Score on Mortality, Length of Stay, Mobility and the Destination of Discharge of Geriatric Hip Fracture Patients

Abstract

Tom Knauf,1 Benjamin Buecking,2 Lukas Geiger,1 Juliana Hack,1 Ruth Schwenzfeur,3 Matthias Knobe,4 Daphne Eschbach,1 Steffen Ruchholtz,1 Rene Aigner1 On behalf of the Registry for Geriatric Trauma DGU1Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Marburg, Germany; 2Department for Trauma Surgery, Klinikum Hochsauerland, Arnsberg, Germany; 3Working Committee on Geriatric Trauma Registry of the German Trauma Society (DGU), München, Germany; 4Department of Orthopaedic and Trauma Surgery, Cantonal Hospital Lucerne, Lucerne, SwitzerlandCorrespondence: Tom Knauf, Tel [phone], Fax [phone], Email [email protected]: The German Society for Geriatrics recommends the “ISAR” questionnaire as a screening tool for patients ≥ 70 for geriatric screening in emergency rooms. Although the ISAR-score is collected routinely in the “AltersTraumaRegister DGU®” (ATR-DGU), to date less is known about the predictive value of the “ISAR”-score in geriatric trauma patients.Patients and Methods: Currently, 84 clinics participate in the ATR-DGU. This evaluation is limited to the subgroup of proximal femur fractures from 2016– 2018. Patients ≥ 70 years, who underwent surgery for a hip fracture are included in the ATR-DGU. In this evaluation, the influence of the “ISAR”-score on mortality, length of stay, mobility and the destination of discharge was examined.Results: Overall 10,098 patients were included in the present study. The median age was 85 years (interquartile range (IQ) 80– 89 years). According to the ISAR-score 80.6% (n=8142) of the patients were classified as geriatric patients (cut off “ISAR”-score ≥ 2 points). These group of patients had a length of stay of 16 days (IQ10.1– 22.1) compared to the non-geriatric patient cohort showing a length of stay of 15 days (IQ10.1– 20.1). Patients showing an ISAR-score ≥ 2 had an increased risk of being discharged to a nursing home (OR 8.25), not being able to walk (OR 12.52) and higher risk of mortality (OR 3.45).Conclusion: The “ISAR”-score shows predictive power for the length of stay, mobility, hospital mortality and discharge after hospital in the collective of geriatric trauma patients. It therefore seems suitable as a screening tool for geriatric trauma patients in the emergency department and should be considered in this context.Keywords: ISAR-score, hip fracture, geriatric patient, identification of seniors at risk

Keywords

• isar-score
• hip fracture
• geriatric patient
• identification of seniors at risk