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J Korean Soc Emerg Med > Volume 32(6); 2021 > Article
Journal of The Korean Society of Emergency Medicine 2021;32(6): 485-492.
응급실에서 사용되는 노쇠 선별도구들 간의 비교: 체계적 고찰
이지환 , 김민정 , 유제성 , 박유석 , 정현수 , 박인철 , 정성필
연세대학교 의과대학 응급의학교실
Comparison among frailty screening tools in the emergency department: a systematic review
Ji Hwan Lee , Min Joung Kim , Je Sung You , Yoo Seok Park , Hyun Soo Chung , In Cheol Park , Sung Phil Chung
Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea
Correspondence  Sung Phil Chung ,Tel: 02-2019-3030, Fax: 02-2019-4820, Email: EMSTAR@yuhs.ac,
Received: July 31, 2020; Revised: November 6, 2020   Accepted: November 6, 2020.  Published online: December 31, 2021.
It is important to identify high-risk elderly patients in the emergency department (ED), and various screening tools should be used. This study aimed to find the most appropriate tool by comparing frailty screening tools used in the ED.
The authors searched PubMed, EMBASE, Cochrane library, and KoreaMed databases for medical literature. Two or more frailty screening tools were studied. Sensitivities and values of the area under the receiver operating characteristic curve of each tool used in individual studies were compared.
After the screening process, six studies using 12 tools were selected. Most of the tools had low sensitivities. The sensitivities were 90% or more in case of the Clinical Frailty Scale (CFS) and Program of Research to Integrate Services for the Maintenance of Autonomy (PRISMA-7). Seniors at Risk (ISAR) tools for frailty screening, Vulnerable Elders Survey (VES-13) and Geriatric (G8) tools were identified for predicting postoperative mortality, and CFS, Fried and Stable, Unstable, Help to walk, Bedbound (SUHB) tools were used for determining bad composite outcomes. The areas under the curve values predicting outcome were as follows: 0.63-0.67 for death, 0.52-0.64 for postoperative death, 0.52-0.68 for postoperative adverse outcome, 0.55-0.64 for poor prognosis, 0.65-0.69 for activity daily living disability, 0.66-0.78 for functional decline, 0.58-0.61 for hospitalization, 0.57-0.59 for fall, and 0.77-0.91 for frailty screening.
It was difficult to select the most appropriate tool among the 12 frailty tools included in this review. However, Fatigue, Resistance, Ambulation, Illnesses, Loss of weight (FRAIL), Study of Osteoporotic Fracture (SOF), CFS, VES-13, and PRISMA-7 were relatively useful in the ED.
Key words: Frailty; Emergency patients; Elderly; Review
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