PRISMA-7 and the risk of short-term age-related adverse emergency room events


Rapidly screening and estimating the risk of long LOS in the Emergency Room, as well as in hospital after admission from the ER, in older inpatients is relevant as it can help prioritize simple protective interventions.
Screening of older patients presenting a high risk of long LOS upon arrival to the ER is, therefore, the first step of an effective hospital care plan.
Several clinical tools have been proposed to this end, but most of them screen for frailty or chance of frailty-related adverse events after ER discharge. In Quebec, the “Programme de Recherche sur l’Intégration des Services pour le Maintien de l’Autonomie” (PRISMA-7) is the reference tool which is promoted by the Ministry of Health and Social Services for use in ERs and acute care wards. This tool, which separates older patients in two risk levels (i.e., low versus high), has never been validated for its predictive value relatively to the risk of long LOS.
Thus, examining the association of PRISMA-7 risk levels with long LOS in ER could be helpful with regard to the choice of prognostic tools.


  • To examine the relationship between the risk stratification level of PRISMA-7 and LOS in ER, in older adults visiting the ED of the Jewish General hospital.


A score of PRISMA-7 ≥ 7 is associated with increased LOS in ER and in
hospital after admission through ER.


To compare the predictive value of PRISMA-7 with ER2 for LOS prediction, by
analyzing the database of the ER2 pre-post interventional study.


Faculty of Medicine, McGill University
Emergency Department, Jewish General Hospital