The Risk Instrument for Screening in the Community (RISC): a new instrument for predicting risk of adverse outcomes in community dwelling older adults

Hdl Handle:
http://hdl.handle.net/10147/574611
Title:
The Risk Instrument for Screening in the Community (RISC): a new instrument for predicting risk of adverse outcomes in community dwelling older adults
Authors:
O’Caoimh, Rónán; Gao, Yang; Svendrovski, Anton; Healy, Elizabeth; O’Connell, Elizabeth; O’Keeffe, Gabrielle; Cronin, Una; Igras, Estera; O’Herlihy, Eileen; Fitzgerald, Carol; Weathers, Elizabeth; Leahy-Warren, Patricia; Cornally, Nicola; Molloy, D. W
Citation:
BMC Geriatrics. 2015 Jul 30;15(1):92
Issue Date:
30-Jul-2015
URI:
http://dx.doi.org/10.1186/s12877-015-0095-z; http://hdl.handle.net/10147/574611
Abstract:
Abstract Background Predicting risk of adverse healthcare outcomes, among community dwelling older adults, is difficult. The Risk Instrument for Screening in the Community (RISC) is a short (2–5 min), global subjective assessment of risk created to identify patients’ 1-year risk of three outcomes:institutionalisation, hospitalisation and death. Methods We compared the accuracy and predictive ability of the RISC, scored by Public Health Nurses (PHN), to the Clinical Frailty Scale (CFS) in a prospective cohort study of community dwelling older adults (n = 803), in two Irish PHN sectors. The area under the curve (AUC), from receiver operating characteristic curves and binary logistic regression models, with odds ratios (OR), compared the discriminatory characteristics of the RISC and CFS. Results Follow-up data were available for 801 patients. The 1-year incidence of institutionalisation, hospitalisation and death were 10.2, 17.7 and 15.6 % respectively. Patients scored maximum-risk (RISC score 3,4 or 5/5) at baseline had a significantly greater rate of institutionalisation (31.3 and 7.1 %, p < 0.001), hospitalisation (25.4 and 13.2 %, p < 0.001) and death (33.5 and 10.8 %, p < 0.001), than those scored minimum-risk (score 1 or 2/5). The RISC had comparable accuracy for 1-year risk of institutionalisation (AUC of 0.70 versus 0.63), hospitalisation (AUC 0.61 versus 0.55), and death (AUC 0.70 versus 0.67), to the CFS. The RISC significantly added to the predictive accuracy of the regression model for institutionalisation (OR 1.43, p = 0.01), hospitalisation (OR 1.28, p = 0.01), and death (OR 1.58, p = 0.001). Conclusion Follow-up outcomes matched well with baseline risk. The RISC, a short global subjective assessment, demonstrated satisfactory validity compared with the CFS.
Language:
en
Keywords:
OLDER PEOPLE; RISK ASSESSMENT; COMMUNITY HEALTH

Full metadata record

DC FieldValue Language
dc.contributor.authorO’Caoimh, Rónánen
dc.contributor.authorGao, Yangen
dc.contributor.authorSvendrovski, Antonen
dc.contributor.authorHealy, Elizabethen
dc.contributor.authorO’Connell, Elizabethen
dc.contributor.authorO’Keeffe, Gabrielleen
dc.contributor.authorCronin, Unaen
dc.contributor.authorIgras, Esteraen
dc.contributor.authorO’Herlihy, Eileenen
dc.contributor.authorFitzgerald, Carolen
dc.contributor.authorWeathers, Elizabethen
dc.contributor.authorLeahy-Warren, Patriciaen
dc.contributor.authorCornally, Nicolaen
dc.contributor.authorMolloy, D. Wen
dc.date.accessioned2015-08-17T13:35:46Zen
dc.date.available2015-08-17T13:35:46Zen
dc.date.issued2015-07-30en
dc.identifier.citationBMC Geriatrics. 2015 Jul 30;15(1):92en
dc.identifier.urihttp://dx.doi.org/10.1186/s12877-015-0095-zen
dc.identifier.urihttp://hdl.handle.net/10147/574611en
dc.description.abstractAbstract Background Predicting risk of adverse healthcare outcomes, among community dwelling older adults, is difficult. The Risk Instrument for Screening in the Community (RISC) is a short (2–5 min), global subjective assessment of risk created to identify patients’ 1-year risk of three outcomes:institutionalisation, hospitalisation and death. Methods We compared the accuracy and predictive ability of the RISC, scored by Public Health Nurses (PHN), to the Clinical Frailty Scale (CFS) in a prospective cohort study of community dwelling older adults (n = 803), in two Irish PHN sectors. The area under the curve (AUC), from receiver operating characteristic curves and binary logistic regression models, with odds ratios (OR), compared the discriminatory characteristics of the RISC and CFS. Results Follow-up data were available for 801 patients. The 1-year incidence of institutionalisation, hospitalisation and death were 10.2, 17.7 and 15.6 % respectively. Patients scored maximum-risk (RISC score 3,4 or 5/5) at baseline had a significantly greater rate of institutionalisation (31.3 and 7.1 %, p < 0.001), hospitalisation (25.4 and 13.2 %, p < 0.001) and death (33.5 and 10.8 %, p < 0.001), than those scored minimum-risk (score 1 or 2/5). The RISC had comparable accuracy for 1-year risk of institutionalisation (AUC of 0.70 versus 0.63), hospitalisation (AUC 0.61 versus 0.55), and death (AUC 0.70 versus 0.67), to the CFS. The RISC significantly added to the predictive accuracy of the regression model for institutionalisation (OR 1.43, p = 0.01), hospitalisation (OR 1.28, p = 0.01), and death (OR 1.58, p = 0.001). Conclusion Follow-up outcomes matched well with baseline risk. The RISC, a short global subjective assessment, demonstrated satisfactory validity compared with the CFS.en
dc.language.isoenen
dc.subjectOLDER PEOPLEen
dc.subjectRISK ASSESSMENTen
dc.subjectCOMMUNITY HEALTHen
dc.titleThe Risk Instrument for Screening in the Community (RISC): a new instrument for predicting risk of adverse outcomes in community dwelling older adultsen
dc.language.rfc3066enen
dc.rights.holderO'Caoimh et al.en
dc.date.updated2015-08-14T13:23:45Zen
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