Evidence map›Paper›PMID 31170929›Full record

Observational studyBMC geriatrics2019

Screening for older inpatients at risk for long length of stay: which clinical tool to use?

Olivier Beauchet, Shek Fung, Cyrille P Launay, Liam Anders Cooper-Brown, Jonathan Afilalo, Paul Herbert, Marc Afilalo, Julia Chabot

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC geriatrics, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Observational
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Olivier BeauchetDepartment of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, 3755 chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1E2, Canada. olivier.beauchet@mcgill.ca.ORCID 0000-0003-2534-4830
Shek FungDepartment of Medicine, Division of Geriatric Medicine, St. Mary's Hospital Center, McGill University, Montreal, Quebec, Canada.
Cyrille P LaunayGeriatric Medicine and Geriatric Rehabilitation ServiceDepartment of Medicine, Lausanne University Hospital, Lausanne, Switzerland.
Liam Anders Cooper-BrownCentre of Excellence on longevity of McGill integrated University Health Network, Montreal, Quebec, Canada.
Jonathan AfilaloDivision of Cardiology and Centre for Clinical Epidemiology, Jewish General Hospital and McGill University, Montreal, Quebec, Canada.
Paul HerbertDepartment of medicine, Montreal university Hospital and University of Montreal, Montreal, Quebec, Canada.
Marc AfilaloEmergency Department, Jewish General Hospital, McGill University, Montreal, QC, Canada.
Julia ChabotDepartment of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis - Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, 3755 chemin de la Côte-Sainte-Catherine, Montréal, QC, H3T 1E2, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundScreening for inpatients at risk for long length of stay (LOS) is the first step of an effective hospital care plan for older inpatients. This study aims, in older adults admitted to a geriatric acute care ward, to examine and compare the 6-item brief geriatric assessment (BGA) and the "Programme de Recherche sur l'Intégration des Services pour le Maintien de l'Autonomie" (PRISMA-7) risk levels with long LOS, and to establish their performance criteria (i.e., sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratios) for LOS.

methodsBased on an observational, retrospective, cohort design, 166 inpatients aged ≥75 admitted to a geriatric acute care ward of a McGill University-affiliated hospital (Montreal, Quebec, Canada) were recruited. The risk levels of the 6-item BGA (low, moderate and high) and the PRISMA-7 (low versus high) were calculated from a baseline assessment. The LOS was subsequently calculated in number of days.

resultsOnly the 6-item BGA high risk level was associated with a long LOS (Odds ratio = 1.1 with P = 0.028 and Hazard ratio = 2.1 with P = 0.004). Kaplan-Meier distributions showed that there was no significant difference in the delay of hospital discharge between the low and high-risk level reported by the PRISMA-7 (P = 0.381), whereas the 6-item BGA three risk levels differed significantly (P = 0.008), with individuals at high risk levels being discharged later when compared to those with low (P = 0.001) and moderate (P = 0.019) risk levels. Both tools' performance criteria were poor (i.e., < 0.70), except for PRISMA-7's sensitivity which was 100%.

conclusionThe 6-item BGA risk levels were associated with LOS, low risk-level being associated with short LOS and high-risk level with long LOS, but no association was reported with the PRISMA-7 risk levels. Both tools had poor performance criteria for long LOS, suggesting that they cannot be used as prognostic tools with current scientific knowledge.

Indexed as

AgedAged, 80 and overCohort StudiesFemaleGeriatric AssessmentHumansInpatientsLength of StayMaleMass ScreeningPatient DischargePrognosisProspective StudiesQuebecRetrospective StudiesRisk FactorsEpidemiologyFrailtyOlder inpatientsScreening

Identifiers

PMID31170929
PMCPMC6555010

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.