Application of the Variable Indication of Placement (VIP) Tool for Identifying and Prioritising Frail Older Adults in the Emergency Department

Abstract Background Frailty screening in the acute hospital setting is essential for early identification and management of older adults at risk. Several tools exist for this purpose, including the Clinical Frailty Scale (CFS) and the Variable Indication of Placement (VIP) score, a brief screening tool designed to flag potential frailty in older individuals. This study aimed to compare the VIP score with the CFS and assess the strength of association between the two measures. Methods A total of 116 patients aged ≥70 years were included over a period of 7 weeks. Each patient referred for admission and present in the emergency department was screened using the VIP score each morning at 8.30am. All participants subsequently underwent a comprehensive assessment by a specialist older persons team, who assigned a CFS score and initiated appropriate interventions. Frailty was defined as a CFS score ≥4 or a VIP score ≥1. Spearman’s rank correlation coefficient was used to examine the association between the two scores. Results Of the 116 individuals assessed, 86% were identified as frail according to the CFS, while 75% were identified as at risk of frailty by the VIP score. Spearman’s correlation revealed a moderate positive association between the two tools (rho = 0.5763). Conclusion The VIP score demonstrated a moderate positive correlation with the CFS, suggesting it may serve as a useful initial screening tool to support the prioritisation of older people requiring frailty intervention in the emergency department. However, reliance on a single measure may not capture all frail patients, highlighting the importance of comprehensive assessment in this population.