Evidence map›Paper›PMID 39804559›Full record

ArticleGeroScience2025

Enhancing emergency care for older persons: the role and impact of the electronic Frailty Index.

Dana Shiffer, Antonio Desai, Matteo Cesari, Elena Generali, Massimiliano Greco, Gabriele Savioli, Mauro Giordano, Antonio Voza

Abstract read
In one paragraph

Article in GeroScience, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Dana Shiffer *Department of Emergency Medicine, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy. dana.shiffer@humanitas.it.
Antonio Desai *Department of Emergency Medicine, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
Matteo CesariDepartment of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
Elena GeneraliDepartment of Emergency Medicine, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.
Massimiliano GrecoDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
Gabriele SavioliEmergency Department, IRCCS Policlinico San Matteo, Pavia, Italy.
Mauro GiordanoDepartment of Advanced Medical and Surgical Sciences, University of Campania "L. Vanvitelli", Naples, Italy.
Antonio VozaDepartment of Emergency Medicine, IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

As the elderly population expands, enhancing emergency department (ED) care by assessing frailty becomes increasingly vital. To address this, we developed a novel electronic Frailty Index (eFI) from ED health records, specifically designed to assess frailty and predict hospitalization, in-hospital mortality, ICU admissions, and 30-day ED readmissions. This retrospective, single-center study included patients 65 years old or older who presented to the ED of IRCCS Humanitas Research Hospital in Milan, Italy, between January 2015 and December 2019. Frailty was assessed using a novel electronic Frailty Index (eFI), based on the cumulative deficit model, incorporating 45 health deficits to quantify frailty. Patients were divided into four quartiles based on eFI scores to explore the association between frailty levels and adverse outcomes, including hospitalization, in-hospital mortality, ICU admission, and 30-day ED readmission. The study included 21,537 patients (mean age 77.4, 50.7% males). The median eFI score was 0.16. Hospitalization rates rose significantly with frailty, from 20% in the least frail quartile to 43% in the most frail. Similarly, in-hospital mortality and ICU admissions increased markedly with higher eFI scores, with mortality rates climbing from 0.44 to 5.0% across quartiles. The 30-day ED readmission rates significantly rose from 9.9 to 19.8%. For every 0.01 increase in eFI score, the odds of hospitalization, in-hospital mortality, ICU admission, and 30-day ED readmission significantly increased (P < 0.0001). Specifically, the adjusted odds ratios (OR) for hospitalization, in-hospital mortality, ICU admission, and ED readmission rose to 3.55, 14.15, 4.70, and 2.22, respectively (P < 0.0001), in the most frail compared to the least frail quartile. The integration of the eFI into ED settings can enable more precise risk stratification and resource allocation, significantly improving patient management and healthcare delivery for older persons in these urgent care contexts.

Indexed as

Emergency Service, HospitalFrail ElderlyFrailtyGeriatric AssessmentAgedAged, 80 and overElectronic Health RecordsFemaleHospitalizationHospital MortalityHumansIntensive Care UnitsItalyMalePatient ReadmissionRetrospective StudiesElectronic Frailty IndexFrailtyFrailty scoreGeriatricRisk stratification

Identifiers

PMID39804559
PMCPMC12181595

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.