Portuguese older adults presenting at the emergency department: Predictive validity of the Identification of Seniors at Risk (ISAR) tool

Following an emergency department (ED) visit, older adults are more likely to experience poorer outcomes than younger adults. It is crucial to identify older patients using a validated tool. One of the most studied tools is the Identification of Seniors at Risk (ISAR), which is used to identify older adults at risk of adverse outcomes after ED admission. The purpose of the current study was to examine the sensitivity, specificity, and interrater reliability of the Portuguese version of the ISAR when considering early (30 days) and late (180 days) outcomes. Four hundred two older adults presenting in EDs from January 2013 to August 2014 were prospectively enrolled and surveyed. The ISAR threshold (cutoff ≥2) presented a better compromise between sensitivity (81.8% to 88.7%) and specificity (14.7% to 28.1%) when compared to cutoffs ≥1 or ≥3, respectively. Interrater reliability results were very good (0.81 to 0.94). Overall, the Portuguese ISAR appears worthwhile for screening older adults at risk in EDs.