{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T17:46:30Z","timestamp":1793295990208,"version":"4.5.0"},"reference-count":44,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T00:00:00Z","timestamp":1737504000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR001422"],"award-info":[{"award-number":["UL1TR001422"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R33AG058926"],"award-info":[{"award-number":["R33AG058926"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P30AG021342"],"award-info":[{"award-number":["P30AG021342"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Existing risk scores assessing geriatric vulnerability in the emergency department (ED) have shown limited predictive power, especially in diverse populations. We investigated the relationship of a quick and easy\u2010to\u2010administer geriatric vulnerability scoring system with functional decline and mortality in older patients admitted to multiple hospitals through the ED in the United States (US) and Brazil (BR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Federated, international, multicenter observational study of hospitalized ED patients aged \u2265\u200965 from US and BR. The six criteria from the PRO\u2010AGE score (Physical impairment, Recent hospitalization, Older age [\u2265\u200990], Acute mental alteration, Getting thinner, and Exhaustion; 0\u20138; higher scores\u2009=\u2009greater vulnerability) were assessed on admission. We used proportional hazards models to investigate the relationships between PRO\u2010AGE score groups and 90\u2010day mortality and functional decline, defined as new dependence in activities of daily living (ADL) and instrumental ADL (IADL), after adjusting for age, sex, race and ethnicity, education, Charlson comorbidity score, and study site. Death was considered a competing event for the functional decline outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 1390 patients were included (US\u2009=\u2009560; Brazil\u2009=\u2009830). The 90\u2010day risk of death was higher for the upper compared with the lower (reference) PRO\u2010AGE group in both cohorts (US: HR\u2009=\u200911.76; 95% confidence interval [CI]\u2009=\u20092.56\u201354.04; BR: HR\u2009=\u200912.29; 95% CI\u2009=\u20093.54\u201342.59), whereas the risk of new 90\u2010day ADL disability was higher for upper (HR\u2009=\u20092.08; 95% CI\u2009=\u20091.21\u20133.56) and middle groups (HR\u2009=\u20092.10; 95% CI\u2009=\u20091.35\u20133.27) in the US but only the upper group in BR (HR\u2009=\u20091.70; 95% CI\u2009=\u20091.02\u20132.85).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>A higher PRO\u2010AGE score was associated with mortality and functional decline in older ED patients admitted to hospitals in the US and BR, demonstrating its generalizability as a geriatric vulnerability risk score.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.19374","type":"journal-article","created":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T21:03:52Z","timestamp":1737579832000},"page":"1419-1428","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The\n                    <scp>PRO<\/scp>\n                    \u2010\n                    <scp>AGE<\/scp>\n                    Tool and Its Association With Post Discharge Outcomes in Older Adults Admitted From the Emergency Department"],"prefix":"10.1111","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5807-2635","authenticated-orcid":false,"given":"Inessa","family":"Cohen","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine Yale School of Medicine  New Haven Connecticut USA"},{"name":"Department of Biomedical Informatics and Data Science Yale University School of Medicine  New Haven Connecticut USA"},{"name":"Program of Computational Biology and Bioinformatics Yale University  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro K.","family":"Curiati","sequence":"additional","affiliation":[{"name":"Geriatric Emergency Department Research Group (ProAGE) Hospital S\u00edrio\u2010Liban\u00eas  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian V.","family":"Morinaga","sequence":"additional","affiliation":[{"name":"Geriatric Emergency Department Research Group (ProAGE) Hospital S\u00edrio\u2010Liban\u00eas  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Geriatrics Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanish","family":"Gandhi","sequence":"additional","affiliation":[{"name":"The Ohio State University College of Medicine  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katy","family":"Araujo","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Geriatrics Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thiago J.","family":"Avelino\u2010Silva","sequence":"additional","affiliation":[{"name":"Geriatric Emergency Department Research Group (ProAGE) Hospital S\u00edrio\u2010Liban\u00eas  S\u00e3o Paulo Brazil"},{"name":"Geriatric Center for Advanced Medicine Hospital Sirio\u2010Libanes  S\u00e3o Paulo Brazil"},{"name":"Laboratorio de Investigacao Medica em Envelhecimento (LIM\u201066), Servico de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina Universidade de Sao Paulo  S\u00e3o Paulo Brazil"},{"name":"Division of Geriatrics University of California  San Francisco California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luann M.","family":"Bianco","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Geriatrics Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia A.","family":"Brandt","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics and Data Science Yale University School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Capelli","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Geriatrics Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2603-7157","authenticated-orcid":false,"given":"Christopher R.","family":"Carpenter","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Mayo Clinic  Rochester Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9722-2723","authenticated-orcid":false,"given":"Daniel S.","family":"Cruz","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott M.","family":"Dresden","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivy L.","family":"Fishman","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrina","family":"Gipson","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Gray","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Nicole","family":"Hastings","sequence":"additional","affiliation":[{"name":"Center of Innovation to Accelerate Discovery and Practice Transformation Durham VA Health Care System  Durham North Carolina USA"},{"name":"Department of Medicine Duke University School of Medicine  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William W.","family":"Hung","sequence":"additional","affiliation":[{"name":"Brookdale Department of Geriatrics and Palliative Medicine Icahn School of Medicine at Mount Sinai  New York New York USA"},{"name":"Geriatric Research, Education and Clinical Center James J. Peters VA Medical Center  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond","family":"Kang","sequence":"additional","affiliation":[{"name":"Center for Community Health Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mechelle","family":"Lockhart","sequence":"additional","affiliation":[{"name":"Division of Geriatrics &amp; Gerontology, Department of Medicine Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniella","family":"Meeker","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics and Data Science Yale University School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7214-9507","authenticated-orcid":false,"given":"Ugochi","family":"Ohuabunwa","sequence":"additional","affiliation":[{"name":"Division of Geriatrics &amp; Gerontology, Department of Medicine Emory University School of Medicine  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sierra","family":"Ottilie\u2010Kovelman","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Section of Geriatrics Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy F.","family":"Platts\u2010Mills","sequence":"additional","affiliation":[{"name":"Ophirex Inc.  Corte Madera California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5469-6272","authenticated-orcid":false,"given":"Jacqueline","family":"Sandoval","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia","family":"Sifnugel","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine NYU Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary","family":"Taylor","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Northwestern University Feinberg School of Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra F.","family":"Tomasino","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine NYU Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6713-794X","authenticated-orcid":false,"given":"Camille P.","family":"Vaughan","sequence":"additional","affiliation":[{"name":"Division of Geriatrics &amp; Gerontology, Department of Medicine Emory University School of Medicine  Atlanta Georgia USA"},{"name":"VA Atlanta Health Care System Birmingham\/Atlanta Geriatric Research Education and Clinical Center (GRECC)  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7467-1745","authenticated-orcid":false,"given":"M\u00e1rlon J. R.","family":"Aliberti","sequence":"additional","affiliation":[{"name":"Geriatric Emergency Department Research Group (ProAGE) Hospital S\u00edrio\u2010Liban\u00eas  S\u00e3o Paulo Brazil"},{"name":"Geriatric Center for Advanced Medicine Hospital Sirio\u2010Libanes  S\u00e3o Paulo Brazil"},{"name":"Laboratorio de Investigacao Medica em Envelhecimento (LIM\u201066), Servico de Geriatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina Universidade de Sao Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3715-3073","authenticated-orcid":false,"given":"Ula","family":"Hwang","sequence":"additional","affiliation":[{"name":"Geriatric Research, Education and Clinical Center James J. Peters VA Medical Center  Bronx New York USA"},{"name":"Department of Emergency Medicine NYU Grossman School of Medicine  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,1,22]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/emp2.12304"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-021-06960-w"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-024-10576-1"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cger.2012.09.003"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2013.0670"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2007.01400.x"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13670-024-00410-1"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17745"},{"key":"e_1_2_10_10_1","first-page":"327","article-title":"Pragmatic Barriers to Assessing Post\u2010Emergency Department Vulnerability for Poor Outcomes in an Ageing Society","volume":"74","author":"Carpenter C. R.","year":"2016","journal-title":"Netherlands Journal of Medicine"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.16502"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.12569"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1999.tb05204.x"},{"key":"e_1_2_10_14_1","unstructured":"\u201cScreening Tools for High\u2010Risk Older Adults: Which to Choose \u201d2017GEDC (online). accessed July 9 2024 https:\/\/gedcollaborative.com\/article\/screening\u2010tools\u2010high\u2010risk\u2010older\u2010adults\u2010emergency\u2010department\/."},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afz103.84"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03324938"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/emermed-2015-204983"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2020.01.010"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afaa240"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2014.03.025"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.19052"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1963.03060120024016"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2007.01590.x"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.5334\/egems.279"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/amiajnl-2014-002747"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12603-012-0084-2"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-113-12-941"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2024.105038"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.14888"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2023.154370"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.18126"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.7501"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2010.02767.x"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1089\/rej.2011.1239"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/emp2.13084"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12910-022-00819-3"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arr.2023.102082"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/59.3.M255"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.050051"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.1471"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19031829"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.akdh.2022.11.007"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.17944"}],"container-title":["Journal of the American Geriatrics Society"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jgs.19374","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T15:11:11Z","timestamp":1762182671000},"score":1,"resource":{"primary":{"URL":"https:\/\/agsjournals.onlinelibrary.wiley.com\/doi\/10.1111\/jgs.19374"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,22]]},"references-count":44,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1111\/jgs.19374"],"URL":"https:\/\/doi.org\/10.1111\/jgs.19374","archive":["Portico"],"relation":{},"ISSN":["0002-8614","1532-5415"],"issn-type":[{"value":"0002-8614","type":"print"},{"value":"1532-5415","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,22]]},"assertion":[{"value":"2024-08-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-22","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}