Comparison between the Identification of Seniors at Risk and Triage Risk Screening Tool in predicting mortality of older adults visiting the emergency department: Results from Indonesia

Aim: Among others, the Identification of Seniors at Risk (ISAR) and Triage Risk Screening Tool (TRST) are widely used screening instruments for risk stratification of older adults visiting the emergency department (ED). In developing countries, such as Indonesia, older patients often present with acute and severe conditions, leading to a high mortality rate, in which the performance of these two instruments have not been studied. This study aimed to measure the performance of the ISAR and TRST to predict 1- and 3-month mortality in older patients visiting the ED in Indonesia. Methods: This was a prospective cohort study of older patients consecutively visiting the ED of Cipto Mangunkusumo Hospital, a national referral hospital in Jakarta, Indonesia, from January to July 2017. The area of under the curve (AUC) of the ISAR and TRST in predicting 1- and 3-month mortality was measured. Results: Of 771 participants, 400 (52.8%) were men. The 1 month-mortality incidence was 22.8% (95% CI 21.3–24.8), and 3-month mortality was 31.2% (95% CI 29.3–33.8). For 1-month mortality, the ISAR showed AN AUC of 0.62 (95% CI 0.57–0.68), whereas the TRST showed an AUC of 0.58 (95% CI 0.52–0.64). For 3-month mortality, the ISAR showed an AUC of 0.60 (95% CI 0.54–0.65), whereas the TRST showed an AUC of 0.57 (95% CI 0.51–0.62). Conclusions: Both instruments showed moderate predictive ability, but the ISAR showed better performance in predicting 1- and 3-month mortality of older patients visiting the ED in Indonesia. Geriatr Gerontol Int 2019; ••: ••–••.