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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.