Evidence map›Paper›PMID 40261576›Full record

ArticleEuropean geriatric medicine2025

Validation of the acutely presenting older patient screener for short term mortality prediction in older patients hospitalized for COVID-19.

Rosalinde A L Smits, Bas F M van Raaij, Steffy W M Jansen, Jessica M van der Bol, Carolien M J van der Linden, Harmke A Polinder-Bos, Hanna C Willems, Ewout W Steyerberg, Maarten van Smeden, Jacobijn Gussekloo and 2 more

Abstract readValidation StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in European geriatric medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

12 authors.

Rosalinde A L SmitsSection Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands. r.a.l.smits@lumc.nl.ORCID http://orcid.org/0000-0002-3444-2988
Bas F M van RaaijSection Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
Steffy W M JansenDepartment of Geriatrics, Catharina Hospital, Eindhoven, The Netherlands.
Jessica M van der BolDepartment of Geriatric Medicine, Reinier de Graaf Hospital, Delft, The Netherlands.
Carolien M J van der LindenDepartment of Geriatrics, Catharina Hospital, Eindhoven, The Netherlands.
Harmke A Polinder-BosDivision of Geriatrics, Department of Internal Medicine, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Hanna C WillemsSection Geriatrics, Department of Internal Medicine, Amsterdam University Medical Center, Location AMC, Amsterdam, The Netherlands.
Ewout W SteyerbergDepartment of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, The Netherlands.
Maarten van SmedenJulius Center for Health Sciences and Primary Care, Utrecht University Medical Center, Utrecht, The Netherlands.
Jacobijn GusseklooDepartment of Public Health and Primary Care, LUMC Center for Medicine for Older People, Leiden University Medical Centre, Leiden, The Netherlands.
Simon P MooijaartSection Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Centre, Leiden, The Netherlands.
Stella TrompetSection Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.

Funding

ZonMw 10430102110005
6 · The paper itself

Abstract

purposeThe aim of this study was to validate the acutely presenting older patient (APOP) screener, routinely used on the Emergency Department to predict risk of adverse outcomes in older people, for prediction of in-hospital mortality and 30-days-mortality in older patients hospitalized for COVID-19.

methodsPatients ≥ 70 years from a multicenter cohort hospitalized for COVID-19 with measured APOP risk were included. External validation analysis of the APOP screener for in-hospital mortality and 30-days-mortality was performed including discrimination and calibration.

results389 patients (median age 80 (IQR 75-85) years, 41.4% female, 138 APOP high risk) were included. APOP high risk patients more often lived institutionalized, (26% vs. 4%; p < 0.001), had more comorbidities (Charlson Comorbidity Index 2 (1-3) vs. 2 (0-3); p = 0.002) and were less often fit (Clinical Frailty Scale 1-3 17% vs. 62%; p < 0.001). 84 patients died in hospital and 114 within 30 days. APOP high risk patients had a higher risk of in-hospital-death [OR 1.6 (95% CI 1.0-2.6)] and death within 30 days [OR 2.7 (95% CI 1.7-4.2)]. The APOP screener discriminated poorly for in-hospital mortality [AUC 0.56 (95% CI 0.48-0.63)] and for 30-days-mortality [AUC 0.62 (95% CI 0.55-0.68)]. Calibration plots revealed overestimation of the screener for both mortality risks.

conclusionThe APOP screener had a poor predictive performance for in-hospital mortality and 30-days-mortality in older people hospitalized for COVID-19. Screening tools routinely used on the ED may not be useful to predict mortality in different than usual clinical circumstances such as during a pandemic of a novel disease.

Indexed as

COVID-19Geriatric AssessmentHospital MortalityAgedAged, 80 and overComorbidityEmergency Service, HospitalFemaleHospitalizationHumansMaleRisk AssessmentSARS-CoV-2MortalityOlder patientsScreening instrumentValidation

Identifiers

PMID40261576
PMCPMC12378732

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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.