Systematic Review and Meta-analysis of Studies on the Use of Shock Index in Emergency Departments

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37 Questions

What is the cut-off score on the CBS that suggests severe burden or burnout?

25/30

Which test was used to compare frequency distributions in the statistical analysis?

Fisher’s exact test

What is the median CFS score at screening for the included patients in this analysis?

4 (3–5)

How was accuracy in predicting outcomes assessed?

With the area under the curve (AUC) of the receiver operating characteristic (ROC) curve

What percentage of the sample were classified as frail after the CGA?

61%

What is the purpose of using the 'surprise question' (SQ) in the study conducted by Gaffney et al.?

To predict the need for palliative care

Which department at the University Hospital Galway was involved in the study?

Department of Geriatric and Stroke Medicine

What is the primary focus of the Special Issue to which this article belongs?

Frailty in the Elderly: Issues and Challenges

What was the age criterion for the patients included in the prospective study conducted by Gaffney et al.?

Aged ≥70

In which country are the University Hospital Galway and Mercy University Hospital located?

Ireland

What is the purpose of the 'surprise question' (SQ) mentioned in the text?

To predict the likelihood of mortality within 12 months

What is the main finding regarding patients who tested SQ positive in the study?

They had significantly longer length of stay (LOS)

What is the relationship between being SQ positive and frailty?

Being SQ positive was associated with higher odds of frailty

What aspect of older adults attending ED is emphasized in relation to the SQ?

Their greater risk of death compared to non-frail patients

What is the pressing need identified in the text in relation to older people attending ED?

The need to assess their goals of care on presentation to hospital

What was the outcome of the diagnostic accuracy of the 'Surprise Question' (SQ) when predicting one-year mortality?

Low sensitivity and high specificity

What was the most significant finding regarding patients who were SQ positive according to the study?

Reduced survival times

What was the diagnostic accuracy of the 'Surprise Question' (SQ) when predicting admission to the emergency department (ED)?

Low sensitivity and specificity

What was the most significant correlation observed with the 'Surprise Question' (SQ)?

RISC score (r = −0.68)

What was the median length of stay (LOS) for those admitted to the hospital?

8 days

What is the purpose of a comprehensive geriatric assessment (CGA)?

To assess an older person's medical, functional, and social needs

What is the FRAIL scale used for in determining frailty status?

To score the patient's level of frailty from not frail to most frail

Who conducts the detailed comprehensive geriatric assessment (CGA) in the study?

Consultant geriatrician blind to the results of the short screens

What measures are used to determine frailty status in addition to the FRAIL scale and Groningen frailty indicator (GFI)?

Risk Instrument for Screening in the Community (RISC) mortality sub-score and Euroqol EQ-5D quality of life (QOL)

Why were patients admitted from nursing homes excluded from the study?

Due to their high mortality risk and low life expectancy

What is the main reason for the differences in accuracy between studies of the 'Surprise Question' in different specialties?

Length of the patient-physician relationship in different specialties

What does the study suggest about using the 'Surprise Question' as a stand-alone measure of increased risk?

It should not be used as a surrogate to diagnose frailty

What is the suggested benefit of using the 'Surprise Question' in a multidisciplinary setting?

To prompt action on advance care planning

What is indicated by the correlation between the 'Surprise Question' and higher caregiver burden?

Caregivers of patients identified as SQ positive are more likely to experience carer burden

What is highlighted as a limitation of the study?

Exclusion of patients attending ED but discharged outside of core working hours

What was a limitation of the study related to the number of patients with specific presenting conditions?

The number of patients with specific presenting conditions was small, preventing sub-analysis.

What was the impact of not conducting inter-reliability testing for the SQ?

It introduced potential bias and limited the reliability of the SQ.

Why were nursing staff in the ED not scoring the SQ?

They lacked the necessary training to administer the SQ.

How did the relatively high prevalence of death in the sample potentially influence the findings of the study?

It potentially reduced the diagnostic accuracy of the study.

What effect did being SQ+ have on the patients according to the text?

They had greater levels of multi-morbidity and were frailer.

What does it mean when it mentions 'spectrum bias' in relation to the study?

The study's findings were impacted by certain characteristics of patients included in the sample.

What aspect of patients was well-matched in terms of age, gender, body mass, and cognition in the study?

Their age, gender, body mass, and cognition

This quiz covers the findings of a systematic review and meta-analysis of studies regarding the use of Shock Index in emergency departments. It discusses the predictive validity, AUC values, and the limited studies examining its use in emergency departments. The quiz provides insights into the accuracy and use of Shock Index in different medical specialties.

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