Prognostic Factors of Hospitalization for Patients Aged 75 and Over in Emergency Department in France - Monocentric Retrospective Cohort Study - PROFACTHOS
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 967
- 试验地点
- 1
- 主要终点
- To evaluate the prognostic performance of GAPS in a population of patients aged 75 and over admitted to emergency departments in France
研究概览
简要总结
A geriatric patient is defined as a patient aged 75 and over who meets certain medical or social vulnerability criteria and is characterised by coexisting physical and/or psychological dependence. The proportion of patients with a geriatric profile in the general population is growing. The average time spent in the emergency department by the elderly population is about 3 hours longer than for patients under 75 years old in France, which is associated with the risk of decompensation of chronic conditions, confusion, falls or agitation. An overnight stay in the emergency department for these patients increases the risk of mortality and the length of hospital stay.
Several prognostic scores for hospitalization have been studied in adult populations. The most widely used scores are the Sydney Triage to Admission Risk Tool (START), the Ambulatory (AMB) and the Glasgow Admission Prediction Score (GAPS). Studies have compared these three scores and demonstrated the greater robustness of GAPS. The CalcuLation of the Elderly Admission Risk in the Emergency Department (CLEARED) tool, developed for the elderly population, has lower performance than GAPS. A systematic review of the literature studied the power of GAPS for the geriatric population and highlighted the need for validation in the target population. No validated hospitalization prognostic score was found in France for this population. The research hypothesis is that GAPS would detect hight probability of admission at the time of triage for the patients aged 75 and over in emergency department in France. The primary objective of this monocentric study is to evaluate the prognostic performance of GAPS for the target population (on the group 1). The secondary objectives consist of developing and internally validating a new score (PROFACTHOS) (on the group 2), then performing a temporal validation of PROFACTHOS with comparison to the GAPS (on the group 1), and finally to determine the threshold for classifying patients with a high probability of hospitalization for the score with the strongest discriminatory performance among GAPS or PROFACTHOS.
Group 1: Patients aged 75 and over admitted to emergency department from 10/01/2024 to 09/30/2025.
Group 2 : Patients aged 75 and over admitted to emergency department from 10/01/2022 to 09/30/2023
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 75 Years 至 —（Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Adult over or equal 75 years old
- •Patient admitted to the emergency department between 10/01/2022 and 09/30/2023 for the second group, and between 10/01/2024 and 09/30/2025 for the first group
- •Patient and/or family and/or trusteeship who doesn't refused to participate
排除标准
- •Patient died before admitted to emergency department
- •Patient already included in the study
- •File created by mistake, identified by the mention "Erreur de dossier"
- •Patient deprived of total or partial liberty by a judicial or administrative decision
结局指标
主要结局
To evaluate the prognostic performance of GAPS in a population of patients aged 75 and over admitted to emergency departments in France
时间窗: 1 day
The performance of GAPS will be evaluated by measuring the area under the ROC (receiver operating characteristic) curve (AUC) with the population of group 1.
次要结局
- To develop a prognostic hospitalization score (PROFACTHOS) based on data from the patient's initial clinical exam.(1 day)
- Temporal validation of the hospitalization prognostic score PROFACTHOS(1 day)
- To compare the performance of both scores GAPS and PROFACTHOS(1 day)
- To determine the threshold for classifying patients with a high probability of hospitalization for the score with the strongest discriminatory performance among GAPS or PROFACTHOS(1 day)