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Master Thesis

Comparaison du sens clinique du gériatre et du score TRST pour l’estimation du risque de ré hospitalisation à un mois

Abstract : Introduction: unplanned readmissions in older population are frequent and deleterious. The « Triage Risk Screen Tool » (TRST) is one of the clinical risk scores available to predict the risk for readmission. We hypothesized that the clinical judgment of the geriatrician was more efficient than TRST to predict 30-day hospital readmission. Methods: all consecutive patients aged over 75y admitted to the Geriatric Departments (Bordeaux University Hospital) and discharged to their initial place of living were prospectively enrolled in the study. A continuous scale from 0 to 100 was used by senior geriatrician to assess the risk for 30-day hospital readmission. A phone call to the patient, relatives or general practitioner was carried out 30 days after discharge to collect his survival status. Result: 191 patients were enrolled (mean age 87, 58% women) between December 2018 and April 2019. The majority of patients (81%) lived at home, mainly) with a caregiver (146 (76%)). The mean Charlson score was high (6,5±1,3). The two main reasons for admission were fall and dyspnea. The 30-day hospital readmission was 26.5%, mainly for the same reason (82%). A threshold of 20% was defined using the ROC curve of the Geriatrician’s Clinical Sense, in order to find a satisfactory sensitivity. Geriatrician’s Clinical judgment and TRST ROC curves were not significantly different (p = 0,16). Conclusion: the Geriatrician abilities to predict the risk for a 30-day hospital readmission was not more efficient than TRST.
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Master Thesis
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Émilie Clabé. Comparaison du sens clinique du gériatre et du score TRST pour l’estimation du risque de ré hospitalisation à un mois. Médecine humaine et pathologie. 2019. ⟨dumas-02517908⟩

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