A new risk assessment model delivered over electronic health records (EHRs) worked well to predict an older adult’s critical illness within a year of a primary care visit. Authors said the findings could serve as a basis for testing and enacting preventive strategies to promote the well-being of older adults at risk for life-threatening illnesses.
The research involved creating and assigning an Elders Risk Assessment (ERA) score to identify older adults who were at risk, according to the study published March 7 in Journal of the American Geriatrics Society.
This isn’t the first time the ERA score has been assessed; previous research has examined using it to predict nursing home placement as well as other factors such as risk for fractures, the authors noted. The scale, which ranges from -1 to 34, is readily available and visible in the EHR so it’s easy for clinicians to see (and take action).
“While the ERA score is utilized in our primary care practice for implementing and measuring transition programs and facilitating discussions on goals of care, it has not been routinely employed to assess the risks of critical illness and mortality and serve as a trigger for preventive action during primary care visits,” the team wrote.
Researchers evaluated data from 12,885 people who were 65 years old and up. The participants all had primary care visits at the Mayo Clinic in Rochester, Minnesota, between 2019 and 2021. The median age of participants was 75 years old, and 44.6% were male.
The team members gleaned demographic data from the time of the primary care visit such as age, sex, comorbidities, hospital stays within a two-year span, and then assigned an ERA score to each person. The team also looked at emergency department visits, use of ventilators and how long people had inpatient stays.
Of the participants, 11.3% were admitted to the intensive care unit or died within one year of the visit.
The ERA score predicted critical illness well, the researchers found. People with an ERA score of nine were considered prime for implementing and testing potential preventive strategies.
