Abstract
Geriatric patients in emergency department (ED) represent 40 % of all admissions and 6.5 % are over 80 years of age. Up to two thirds are acutely admitted to hospital and part of those discharged presents repeatedly in ED.
Increasing medical complexity of older persons and concurrent social care needs mean that - in addition to the treatment of acute clinical condition - other geriatric syndromes have to be assessed and diagnosed. These conditions may play a key role in decision-making process regarding hospital admission, and negatively influence health care oucomes and health services use.
In the paper two assessment tools are presnetd - ISAR and TRST - designed primarily for stratification of geriatric patients according their risk of negative health outcomes (mortality, disability, repeated ED admissions, length of hospital stay, rehospitaization). Both tools were piloted at general medicine ED at General Faculty Hospital in Prague.
We confirmed their feasibility and validity for risk prediction in the Czech health care system. Based on literature data we assume that targeted geriatric intervention to high risk patients (e.g. geriatric consultation in hospitalized) and management of health and social community service provision may reduce ED visits and hospital readmissions.
Future research should focus on evidence-based benefit of interventions.