Hong Kong Med J 2011;17(Suppl 3):S4-7
Emergency department intervention for high-risk elders: identification strategy and randomised controlled trial to reduce hospitalisation and institutionalisation
VWT Yim, TH Rainer, CA Graham, J Woo, TW Wong, FL Lau, SM Ting
Accident and Emergency Medicine Academic Unit, The Chinese University of Hong Kong, Prince of Wales Hospital
1. A six-item self-reported screening questionnaire — Hong Kong identification of seniors at risk (HK-ISAR) — was developed for elders attending the emergency department (ED) deemed to be at increased risk of adverse health outcomes.
2. The HK-ISAR is the first validated screening tool for use in an ED setting in Hong Kong. It addressed health outcomes such as activities of daily living, dependence, history of hospitalisation, and polypharmacy.
3. Among the six questions in the HK-ISAR, attendance at a hospital ED during the past month was the most important predictor of poor subsequent health outcome.
4. The sensitivity and specificity of the HK-ISAR for predicting a poor health outcome was 68.3% and 49.4%, respectively, with an area under the receiver operating characteristic curve of 0.621.
5. A randomised controlled trial of a community-based structured interventional programme found no difference in the 6-month outcomes of patients screened positive (receiving the intervention) or negative (receiving usual care) according to the HK-ISAR.