Di Bari et al reported the Silver Code to aid in triaging an older adult in the Emergency Department (ED). This can help to identify an older adult who may require more aggressive management. The authors are from multiple institutions in Italy.
Patient selection: older adult in the ED, age >= 75 years, admission for medical reason
Parameters:
(1) age in years
(2) sex
(3) marital status
(4) previous admission to a day hospital
(5) previous admission to a regular ward and discharge diagnosis
(6) number of drugs in the previous 3 months
Parameter
Finding
Points
age in years
75 to 79 years
0
80 to 84 years
3
>= 85 years
9
sex
female
0
male
2
marital status
married
0
unmarried, widowed, divorced
1
previous admission to day hospital
no
0
yes
5
previous admission to regular ward
no
0
yes, respiratory disease
6
yes, cancer
11
yes, other
2
number of drugs
< 8
0
>= 8
2
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 30
• The higher the score the greater the one-year mortality.
Total Score
Mortality Rate per 100 Person Years
0 to 3
24.3
4 to 6
36.8
7 to 10
56.7
>= 11
78.0
Performance:
• The area under the ROC curve is 0.66.
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