Garcia-Pérez, D.; Vena-Martínez, A.; Robles-Perea, L.; Roselló-Padullés, T.; Espaulella-Panicot, J.; Arnau, A. Prognostic Value of a New Tool (the 3D/3D+) for Predicting 30-Day Mortality in Emergency Department Patients Aged 75 Years and Older. J. Clin. Med.2023, 12, 6469.
Garcia-Pérez, D.; Vena-Martínez, A.; Robles-Perea, L.; Roselló-Padullés, T.; Espaulella-Panicot, J.; Arnau, A. Prognostic Value of a New Tool (the 3D/3D+) for Predicting 30-Day Mortality in Emergency Department Patients Aged 75 Years and Older. J. Clin. Med. 2023, 12, 6469.
Garcia-Pérez, D.; Vena-Martínez, A.; Robles-Perea, L.; Roselló-Padullés, T.; Espaulella-Panicot, J.; Arnau, A. Prognostic Value of a New Tool (the 3D/3D+) for Predicting 30-Day Mortality in Emergency Department Patients Aged 75 Years and Older. J. Clin. Med.2023, 12, 6469.
Garcia-Pérez, D.; Vena-Martínez, A.; Robles-Perea, L.; Roselló-Padullés, T.; Espaulella-Panicot, J.; Arnau, A. Prognostic Value of a New Tool (the 3D/3D+) for Predicting 30-Day Mortality in Emergency Department Patients Aged 75 Years and Older. J. Clin. Med. 2023, 12, 6469.
Abstract
The 3D/3D+ multidimensional geriatric assessment tool provides an optimal model of emergency care for patients aged 75 and over who attend the Emergency Department (ED). The baseline, or static, component (3D) stratifies the degree of frailty prior to the acute illness, while the current, or dynamic, component (3D+) assesses the multidimensional impact caused by the acute illness and helps to guide the choice of care facility for patients upon their discharge from the ED. The objective of this study was to evaluate the prognostic value of the 3D/3D+ to predict short- and long-term adverse outcomes in ED patients aged 75 years and older. Multivariable logistic regression models were used to identify the predictors of mortality 30 days after 3D/3D+ assessment. Two hundred and seventy-eight patients (59.7% women) with a median age of 86 years (interquartile range: 83-90) were analysed. According to the baseline component (3D), 83.1% (95%CI: 78.2-87.3) presented some degree of frailty. The current component (3D+) presented alterations in 60.1% (95%CI: 54.1-65.9). The choice of care facility at ED discharge indicated by the 3D/3D+ was considered appropriate in 96.4% (95%CI: 93.0-98.0). Thirty-day all-cause mortality was 19.4%. Delirium and functional decline were the dimensions on the 3D/3D+ that were independently associated with 30-day mortality. These two dimensions had an area under receiver operating characteristic of 0.80 (95%CI: 0.73-0.86) for predicting 30-day mortality. 3D/3D+ enhances the provision of comprehensive care by ED professionals, guides them in the choice of patients’ discharge destination, and has a prognostic validity that serves to establish future therapeutic objectives.
Keywords
Emergency department; Elderly; Geriatric assessment; Frailty; Frailty transitions; Mortality; Clinical Frailty Scale; Identification of Seniors at Risk screening tool.
Subject
Medicine and Pharmacology, Emergency Medicine
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
