Using the "Surprise Question" to Predict Frailty and Healthcare Outcomes among Older Adults Attending the Emergency Department.
Int J Environ Res Public Health
; 19(3)2022 Feb 02.
Article
in English
| MEDLINE | ID: covidwho-1674614
ABSTRACT
The "surprise question" (SQ) predicts the need for palliative care. Its predictive validity for adverse healthcare outcomes and its association with frailty among older people attending the emergency department (ED) are unknown. We conducted a secondary analysis of a prospective study of consecutive patients aged ≥70 attending a university hospital's ED. The SQ was scored by doctors before an independent comprehensive geriatric assessment (CGA). Outcomes included length of stay (LOS), frailty determined by CGA and one-year mortality. The SQ was available for 191 patients, whose median age was 79 ± 9. In all, 56/191 (29%) screened SQ positive. SQ positive patients were frailer; the median clinical frailty score was 6/9 (compared to 4/9, p < 0.001); they had longer LOS (p = 0.008); and they had higher mortality (p < 0.001). Being SQ positive was associated with 2.6 times greater odds of admission and 8.9 times odds of frailty. After adjustment for age, sex, frailty, co-morbidity and presenting complaint, patients who were SQ positive had significantly reduced survival times (hazard ratio 5.6; 95% CI 1.39-22.3, p = 0.015). Almost one-third of older patients attending ED were identified as SQ positive. These were frailer and more likely to be admitted, have reduced survival times and have prolonged LOS. The SQ is useful to quickly stratify older patients likely to experience poor outcomes in ED.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Frailty
Type of study:
Cohort study
/
Observational study
/
Prognostic study
Limits:
Aged
/
Humans
Language:
English
Year:
2022
Document Type:
Article
Affiliation country:
Ijerph19031709
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