Predictive validation of a questionnaire for the assessment of social care needs in hospitalized older adults, the geriatric discharge complexity score: a diagnostic accuracy study

Background: Anticipating discharge challenges in the elderly population is essential to support effective care planning and reduce risks during care transitions. However, there is a lack of targeted assessment tools specifically designed for use in hospital wards to address this need. Aims: To evaluate the predictive value of the Geriatric Discharge Complexity Score (GDCS) and Blaylock Risk Assessment Screening Score (BRASS) with respect to discharge difficulties in a population of hospitalized older adults. Methods: The study was conducted on a sample of 416 subjects (175 females) with mean age of 88.2 ± 5.7 years. All subjects underwent evaluation with GDCS, Barthel scale, BRASS and count of total days of hospitalization and days of hospitalization related to social-welfare problems. Results: The GDCS showed sensitivity of 97.9% and specificity of 69.8% with an area under the curve (AUC) of 0.936. The BRASS showed sensitivity of 86.3% and specificity of 20.2% with an AUC of 0.518. Total and excess days of hospitalization for social problems were significantly higher in subjects with elevated GDCS. Conclusion: The GDSC seems more predictive of social care issues that may lead to a prolongation of hospital stay than the BRASS.