Common risk stratification tools, e.g. for triage, fail in older patients. Some attempts have been undertaken to improve triage of older patients with nonspecific markers such as lactate with or without combination with vital signs or other aggregated lab scores.

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References

1. Grossmann FF, Zumbrunn T, Ciprian S, Stephan FP, Woy N, Bingisser R, et al. Undertriage in older emergency department patients-tilting against windmills? PLoS One. 2014;9(8):e106203.
2. Hendin A, Eagles D, Myers V, Stiell IG. Characteristics and outcomes of older emergency department patients assigned a low acuity triage score. CJEM. 2018;20(5):762-9.
3. del Portal DA, Shofer F, Mikkelsen ME, Dorsey PJ, Jr., Gaieski DF, Goyal M, et al. Emergency department lactate is associated with mortality in older adults admitted with and without infections. Acad Emerg Med. 2010;17(3):260-8.
4. Cetinkaya HB, Koksal O, Sigirli D, Leylek EH, Karasu O. The predictive value of the modified early warning score with rapid lactate level (ViEWS-L) for mortality in patients of age 65 or older visiting the emergency department. Intern Emerg Med. 2017;12(8):1253-7.
5. Klausen HH, Petersen J, Bandholm T, Juul-Larsen HG, Tavenier J, Eugen-Olsen J, et al. Association between routine laboratory tests and long-term mortality among acutely admitted older medical patients: a cohort study. BMC Geriatr. 2017;17(1):62.
6. Bindraban R, Ten Berg MJ, Haitjema S et al. Exploring the value of routinely measured haematology parameters for identification of elderly patients at high risk of death at the Emergency Department. Acute Med 2018; 17(4)
7. Romero-Ortuno R, Wallis S, Biram R, Keevil V. Clinical frailty adds to acute illness severity in predicting mortality in hospitalized older adults: An observational study. Eur J Intern Med. 2016;35:24-34.
8. Lucke JA, van der Mast RC, de Gelder J, Heim N, de Groot B, Mooijaart SP, et al. The Six-Item Cognitive Impairment Test Is Associated with Adverse Outcomes in Acutely Hospitalized Older Patients: A Prospective Cohort Study. Dement Geriatr Cogn Dis Extra. 2018;8(2):259-67.