The utility of the Barthel index as an outcome predictor in older patients with acute infection attending the emergency department

Background: Functional decline and frailty are common in older adults and influence the risk of adverse outcomes. We aimed to assess the value of a Barthel index at the Emergency Department (ED-BI) score in predicting 30-day mortality and ED reconsultation among older patients with acute infection.Methods: We performed a prospective multicentre cohort study of older patients (>= 75 years) diagnosed with acute infection in 69 Spanish EDs. Demographic, comorbidities, functional status, clinical and analy-tical data were collected. Unadjusted and adjusted logistic regression models were used to assess the as-sociation between ED-BI score, mortality and ED reconsultation.Results: In total 1596 patients with a mean age of 84.7 years were included in the study and 51.7% female. The most frequent focus of infection was respiratory in 918 patients (57.5%). Patients with an ED-BI < 60 points were significantly older, predominantly female, more likely institutionalized and more urinary in-fections. When comparing patients with an ED-BI score >= 60 points with those < 60 points no differences were found in ED reconsultation but in the latter group mortality at 30-days was higher (p < 0.001).Conclusion: An ED-BI score < 60 points appears to be a strong predictor of mortality at the 30-day follow up in older patients with acute infection. Data availability: The data used to support the findings of this study are included within the article.(c) 2022 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

Automated summary

In older patients with acute infection, an ED-BI score < 60 points appears to be a strong predictor of 30-day mortality. This study has important implications for assessing the risk of adverse outcomes in older patients.