The Geriatric Measurement Tool (GMT) was used in this study prospectively to assess 24 hour mortality rate in ED patients over age 65. The GMT is a combination of FRAIL Questionnaire and Barthel index for Activity of Daily Living. The study found:
“ From 700 enrolled patients, GMT categorization revealed that 53.6% of patients were in Category-4 (moderate/more dependent and frail), while 34% were in Category-1 (independent or slight dependency, prefrail/fit). The 24-h mortality rate was 9%. GMT Category-4 demonstrated high sensitivity (87.3%) for mortality prediction, but low specificity (49.7%). Conversely, GMT Category-1 showed low sensitivity (44.1%) but high specificity (90.2%) for predicting discharge.”
Probably the biggest take away is we should be thinking about assessing our older patient's health status using some validated scale/tool to help us have conversations with patients and families regarding prognosis and interventions.
References
The Role of the Geriatric Measurement Tool in Predicting Clinical Outcomes Among Elderly Patient in the Emergency Department Zaman, Süeda et al. Journal of Emergency Medicine, Volume 79, 560 - 567
