Patient-reported geriatric symptoms as risk factors for hospitalization and emergency department visits

Anupam Chandra, Sarah J. Crane, Ericka E. Tung, Gregory J. Hanson, Frederick North, Stephen S. Cha, Paul Y Takahashi

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

There is an urgent need to identify predictors of adverse outcomes and increased health care utilization in the elderly. The Mayo Ambulatory Geriatric Evaluation (MAGE) is a symptom questionnaire that was completed by patients aged 65 years and older during office visits to Primary Care Internal Medicine at Mayo Clinic in Rochester, MN. It was introduced to improve screening for geriatric conditions. We conducted this study to explore the relationship between self-reported geriatric symptoms and hospitalization and emergency department (ED) visits within 1 year of completing the survey. This was a retrospective cohort study of patients who completed the MAGE from April 2008 to December 2010. The primary outcome was an ED visit or hospitalization within 1 year. Predictors included responses to individual questions in the MAGE. Data were obtained from the electronic medical record and administrative records. Logistic regression analyses were performed from significant univariate factors to determine predictors in a multivariable setting. A weighted scoring system was created based upon the odds ratios derived from a bootstrap process. The sensitivity, specificity, and AUC were calculated using this scoring system. The MAGE survey was completed by 7738 patients. The average age was 76.2 ± 7.68 years and 57% were women. Advanced age, a self-report of worse health, history of 2 or more falls, weight loss, and depressed mood were significantly associated with hospitalization or ED visits within 1 year. A score equal to or greater than 2 had a sensitivity of 0.74 and specificity of 0.45. The calculated AUC was 0.60. The MAGE questionnaire, which was completed by patients at an outpatient visit to screen for common geriatric issues, could also be used to assess risk for ED visits and hospitalization within 1 year.

Original languageEnglish (US)
Pages (from-to)188-195
Number of pages8
JournalAging and Disease
Volume6
Issue number3
DOIs
StatePublished - 2015

Fingerprint

Geriatrics
Hospital Emergency Service
Hospitalization
Area Under Curve
Patient Acceptance of Health Care
Office Visits
Sensitivity and Specificity
Electronic Health Records
Internal Medicine
Self Report
Weight Loss
Primary Health Care
Cohort Studies
Outpatients
Retrospective Studies
Logistic Models
Odds Ratio
Regression Analysis
Surveys and Questionnaires
Health

Keywords

  • Emergency department
  • Geriatric screening
  • Hospitalization

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Cell Biology
  • Clinical Neurology
  • Pathology and Forensic Medicine

Cite this

Patient-reported geriatric symptoms as risk factors for hospitalization and emergency department visits. / Chandra, Anupam; Crane, Sarah J.; Tung, Ericka E.; Hanson, Gregory J.; North, Frederick; Cha, Stephen S.; Takahashi, Paul Y.

In: Aging and Disease, Vol. 6, No. 3, 2015, p. 188-195.

Research output: Contribution to journalArticle

Chandra, Anupam ; Crane, Sarah J. ; Tung, Ericka E. ; Hanson, Gregory J. ; North, Frederick ; Cha, Stephen S. ; Takahashi, Paul Y. / Patient-reported geriatric symptoms as risk factors for hospitalization and emergency department visits. In: Aging and Disease. 2015 ; Vol. 6, No. 3. pp. 188-195.
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