Observational studyBMC geriatrics2026
Association of the barthel index with mortality and intensive care unit admission in older patients presenting to the emergency department.
Observational study in BMC geriatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundIn emergency departments, the use of screening tools that provide a simple and rapid prognosis for elderly patients at high risk is of great importance. The aim of this study was to evaluate the association of functional status and frailty with mortality and intensive care unit admission in older patients presenting to the emergency department.
methodsStudy is prospective and observational. Data were collected using the Barthel Activities of Daily Living Index, FRAIL, and PRISMA-7 scales upon admission to the emergency department for all patients aged 65 years and older who visited the emergency department of Sivas Cumhuriyet University Faculty of Medicine Hospital over a one-month period. At the end of the hospitalisation process, mortality rates from all causes and intensive care admission rates were evaluated.
resultsThe area under the ROC curve for in-hospital mortality, Barthel index, PRISMA-7 and FRAIL scale was 0.698 (95% CI: 0.589–0.807), 0.687 (95% CI: 0.602–0.771) and 0.655 (95% CI: 0.559–0.751), respectively. The sensitivity and specificity of the Barthel Index were 66.7% and 65.0%, respectively; the sensitivity and specificity of PRISMA-7 were 71.4% and 59.2%, respectively; and the sensitivity and specificity of the FRAIL scale were 66.7% and 56.0%, respectively. Our study determined that the Barthel Index had a better balance than PRISMA-7 and FRAIL in terms of sensitivity and specificity and was the most important independent predictor in predicting in-hospital mortality (3.71 times) and ICU admission (3.40 times), although its overall discriminative performance remained moderate.
conclusionIt is believed that the Barthel Index, when assessed at initial admission to the emergency department, has prognostic value in determining the risk of admission to the intensive care unit and in-hospital mortality among elderly patients. The routine use of the Barthel Index in emergency departments as a tool to complement existing clinical parameters can provide important information about patients’ general health status and functional capacity, and may be useful in the planning of healthcare services.
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