A Modified Screening Tool to Evaluate Risk of Unanticipated Return Visits to the Emergency Department in the Geriatric Population

Purpose: To compare the Modified Screening Tool for Identifying at Risk Seniors (mSTIRS) against the Triage Risk Screening Tool (TRST) and the Identification of Seniors at Risk (ISAR) for predictive value and assess the relationship between presenting complaint with unanticipated return visit (URV) occurrence in geriatric patients.Design: A prospective, observational study conducted at a large academic medical center. Descriptive statistics and psychometric analyses were used to analyze the association between demographics, clinical data, and to evaluate the modified screening tool.Methods: 38 geriatric participants in the Emergency Department (ED) were enrolled and 21 completed the study. The screening tools were administered after triage and patients were contacted 72-hours post-discharge from the ED for URV evaluation. Results: The mSTIRS demonstrated greater sensitivity (87.5%), specificity (57.1%), and predictive value (PPV 50%; NPV 88.9%) than the TRST and ISAR. No association was found between URV and presenting complaint (X2(6, n=21) = 3.161, p = 0.788).Conclusions: The mSTIRS screening tool better identified geriatric patients at risk for unanticipated 72-hour return visits to the ED compared to the TRST and ISAR. Additional testing with a larger sample is needed to replicate results and determine the validity of this modified screening tool.