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Aging and Disease    2015, Vol. 6 Issue (3) : 188-195     DOI: 10.14336/AD.2014.0706
Original Article |
Patient-Reported Geriatric Symptoms as Risk Factors for Hospitalization and Emergency Department Visits
Anupam Chandra1(),Sarah J Crane1,Ericka E Tung1,Gregory J Hanson1,Frederick North1,Stephen S Cha2,Paul Y Takahashi1
1Division of Primary Care Internal Medicine, Department of Health Sciences Research; Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
2 Department of Health Sciences Research; Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA
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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.

Keywords emergency department      geriatric screening      hospitalization     
Issue Date: 01 June 2015
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Articles by authors
Anupam Chandra
Sarah J Crane
Ericka E Tung
Gregory J Hanson
Frederick North
Stephen S Cha
Paul Y Takahashi
Cite this article:   
Anupam Chandra,Sarah J Crane,Ericka E Tung, et al. Patient-Reported Geriatric Symptoms as Risk Factors for Hospitalization and Emergency Department Visits[J]. A&D, 2015, 6(3): 188-195.
URL:  
http://www.aginganddisease.org/EN/10.14336/AD.2014.0706     OR     http://www.aginganddisease.org/EN/Y2015/V6/I3/188
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