Prognostic Value of a New Tool (the 3D/3D+) for Predicting 30-Day Mortality in Emergency Department Patients Aged 75 Years and Older

The 3D/3D+ multidimensional geriatric assessment tool provides an optimal model of emergency care for patients aged 75 and over who attend the Emergency Department (ED). The baseline, or static, component (3D) stratifies the degree of frailty prior to the acute illness, while the current, or dynamic...

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Autores: Garcia-Pérez, Dolors, Vena Martínez, Ana Belén, Robles-Perea, Laura, Roselló-Padullés, Teresa, Espaulella-Panicot, Joan, Arnau, Anna
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2023
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10459.1/464758
Acceso en línea:https://doi.org/10.3390/jcm12206469
https://hdl.handle.net/10459.1/464758
Access Level:acceso abierto
Palabra clave:Emergency department
Elderly
Geriatric assessment
Frailty transitions
Mortality
Clinical frailty scale
Identification of seniors at risk screening
Tool
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spelling Prognostic Value of a New Tool (the 3D/3D+) for Predicting 30-Day Mortality in Emergency Department Patients Aged 75 Years and OlderGarcia-Pérez, DolorsVena Martínez, Ana BelénRobles-Perea, LauraRoselló-Padullés, TeresaEspaulella-Panicot, JoanArnau, AnnaEmergency departmentElderlyGeriatric assessmentFrailty transitionsMortalityClinical frailty scaleIdentification of seniors at risk screeningToolThe 3D/3D+ multidimensional geriatric assessment tool provides an optimal model of emergency care for patients aged 75 and over who attend the Emergency Department (ED). The baseline, or static, component (3D) stratifies the degree of frailty prior to the acute illness, while the current, or dynamic, component (3D+) assesses the multidimensional impact caused by the acute illness and helps to guide the choice of care facility for patients upon their discharge from the ED. The objective of this study was to evaluate the prognostic value of the 3D/3D+ to predict short- and long-term adverse outcomes in ED patients aged 75 years and older. Multivariable logistic regression models were used to identify the predictors of mortality 30 days after 3D/3D+ assessment. Two hundred and seventy-eight patients (59.7% women) with a median age of 86 years (interquartile range: 83–90) were analyzed. According to the baseline component (3D), 83.1% (95% CI: 78.2–87.3) presented some degree of frailty. The current component (3D+) presented alterations in 60.1% (95% CI: 54.1–65.9). The choice of care facility at ED discharge indicated by the 3D/3D+ was considered appropriate in 96.4% (95% CI: 93.0–98.0). Thirty-day all-cause mortality was 19.4%. Delirium and functional decline were the dimensions on the 3D/3D+ that were independently associated with 30-day mortality. These two dimensions had an area under receiver operating characteristic of 0.80 (95% CI: 0.73–0.86) for predicting 30-day mortality. The 3D/3D+ tool enhances the provision of comprehensive care by ED professionals, guides them in the choice of patients’ discharge destination, and has a prognostic validity that serves to establish future therapeutic objectives.MDPI2023info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersionhttps://doi.org/10.3390/jcm12206469https://hdl.handle.net/10459.1/464758reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésReproducció del document publicat a: https://doi.org/10.3390/jcm12206469Journal of Clinical Medicine, 2023, vol. 12, núm. 20cc-by (c) autors, 2023Attribution 4.0 Internationalinfo:eu-repo/semantics/openAccesshttp://creativecommons.org/licenses/by/4.0/oai:recercat.cat:10459.1/4647582026-05-29T05:05:01Z
dc.title.none.fl_str_mv Prognostic Value of a New Tool (the 3D/3D+) for Predicting 30-Day Mortality in Emergency Department Patients Aged 75 Years and Older
title Prognostic Value of a New Tool (the 3D/3D+) for Predicting 30-Day Mortality in Emergency Department Patients Aged 75 Years and Older
spellingShingle Prognostic Value of a New Tool (the 3D/3D+) for Predicting 30-Day Mortality in Emergency Department Patients Aged 75 Years and Older
Garcia-Pérez, Dolors
Emergency department
Elderly
Geriatric assessment
Frailty transitions
Mortality
Clinical frailty scale
Identification of seniors at risk screening
Tool
title_short Prognostic Value of a New Tool (the 3D/3D+) for Predicting 30-Day Mortality in Emergency Department Patients Aged 75 Years and Older
title_full Prognostic Value of a New Tool (the 3D/3D+) for Predicting 30-Day Mortality in Emergency Department Patients Aged 75 Years and Older
title_fullStr Prognostic Value of a New Tool (the 3D/3D+) for Predicting 30-Day Mortality in Emergency Department Patients Aged 75 Years and Older
title_full_unstemmed Prognostic Value of a New Tool (the 3D/3D+) for Predicting 30-Day Mortality in Emergency Department Patients Aged 75 Years and Older
title_sort Prognostic Value of a New Tool (the 3D/3D+) for Predicting 30-Day Mortality in Emergency Department Patients Aged 75 Years and Older
dc.creator.none.fl_str_mv Garcia-Pérez, Dolors
Vena Martínez, Ana Belén
Robles-Perea, Laura
Roselló-Padullés, Teresa
Espaulella-Panicot, Joan
Arnau, Anna
author Garcia-Pérez, Dolors
author_facet Garcia-Pérez, Dolors
Vena Martínez, Ana Belén
Robles-Perea, Laura
Roselló-Padullés, Teresa
Espaulella-Panicot, Joan
Arnau, Anna
author_role author
author2 Vena Martínez, Ana Belén
Robles-Perea, Laura
Roselló-Padullés, Teresa
Espaulella-Panicot, Joan
Arnau, Anna
author2_role author
author
author
author
author
dc.subject.none.fl_str_mv Emergency department
Elderly
Geriatric assessment
Frailty transitions
Mortality
Clinical frailty scale
Identification of seniors at risk screening
Tool
topic Emergency department
Elderly
Geriatric assessment
Frailty transitions
Mortality
Clinical frailty scale
Identification of seniors at risk screening
Tool
description The 3D/3D+ multidimensional geriatric assessment tool provides an optimal model of emergency care for patients aged 75 and over who attend the Emergency Department (ED). The baseline, or static, component (3D) stratifies the degree of frailty prior to the acute illness, while the current, or dynamic, component (3D+) assesses the multidimensional impact caused by the acute illness and helps to guide the choice of care facility for patients upon their discharge from the ED. The objective of this study was to evaluate the prognostic value of the 3D/3D+ to predict short- and long-term adverse outcomes in ED patients aged 75 years and older. Multivariable logistic regression models were used to identify the predictors of mortality 30 days after 3D/3D+ assessment. Two hundred and seventy-eight patients (59.7% women) with a median age of 86 years (interquartile range: 83–90) were analyzed. According to the baseline component (3D), 83.1% (95% CI: 78.2–87.3) presented some degree of frailty. The current component (3D+) presented alterations in 60.1% (95% CI: 54.1–65.9). The choice of care facility at ED discharge indicated by the 3D/3D+ was considered appropriate in 96.4% (95% CI: 93.0–98.0). Thirty-day all-cause mortality was 19.4%. Delirium and functional decline were the dimensions on the 3D/3D+ that were independently associated with 30-day mortality. These two dimensions had an area under receiver operating characteristic of 0.80 (95% CI: 0.73–0.86) for predicting 30-day mortality. The 3D/3D+ tool enhances the provision of comprehensive care by ED professionals, guides them in the choice of patients’ discharge destination, and has a prognostic validity that serves to establish future therapeutic objectives.
publishDate 2023
dc.date.none.fl_str_mv 2023
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv https://doi.org/10.3390/jcm12206469
https://hdl.handle.net/10459.1/464758
url https://doi.org/10.3390/jcm12206469
https://hdl.handle.net/10459.1/464758
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv Reproducció del document publicat a: https://doi.org/10.3390/jcm12206469
Journal of Clinical Medicine, 2023, vol. 12, núm. 20
dc.rights.none.fl_str_mv cc-by (c) autors, 2023
Attribution 4.0 International
info:eu-repo/semantics/openAccess
http://creativecommons.org/licenses/by/4.0/
rights_invalid_str_mv cc-by (c) autors, 2023
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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