Biomarkers

Biomarkers in Geriatric Emergency Medicine

Background

Geriatric emergency medicine is challenged by diagnostic and prognostic uncertainty. In older people, acute illness often presents atypically against a background of multimorbidity, frailty, cognitive impairment, and polypharmacy. In the emergency setting, where time pressures and incomplete information are the norm, distinguishing acute pathology from chronic disease, estimating physiological reserve, and predicting outcomes are both crucial and challenging. These uncertainties complicate clinical decision-making and may contribute to both under- and over-diagnosis and/or treatment, potentially exposing older people to harm.

Biomarkers offer a promising means of complementing clinical judgment in managing this uncertainty, by providing insight into underlying pathophysiology, biological ageing, and vulnerability that may not be readily apparent from clinical assessment alone. Biomarkers may thereby support person-centred decision-making through more precise assessment of risk, prognosis, and treatment response.

This special issue, Biomarkers in Geriatric Emergency Medicine, aims to collate research exploring the potential and application of biomarkers to support diagnosis, refine prognostication, inform decision-making, and improve outcomes for older people attending emergency care. We invite contributions spanning a wide range of biological domains and clinical contexts, reflecting the heterogeneity of geriatric emergency presentations. Collectively, this special issue seeks to advance understanding of how biomarker-informed approaches may be integrated into emergency care to support personalized, person-centred management for older people.

Focus and Aims

This special issue focuses on the application of biomarkers in the emergency care of older people, particularly their role in supporting assessment, risk stratification, and clinical management. We welcome submissions investigating diagnostic, prognostic, and predictive biomarkers relevant to common geriatric syndromes and acute presentations, including frailty, delirium, multimorbidity, polypharmacy, critical illness, and end-of-life decision-making.

The aim of this issue is to promote and inform biomarker-based approaches that enhance clinical decision-making, personalize care, and ultimately improve outcomes for older adults presenting to emergency medicine.

Topics of Interest

We welcome research articles, (systematic) reviews, meta-analyses, and methods (methodological papers) addressing (but not limited to):

• Diagnostic biomarkers for acute illness in older emergency department patients.
• Prognostic biomarkers for short- and long-term outcomes, including mortality, functional decline, and readmission.
• Predictive biomarkers for treatment response and clinical trajectory.
• Biomarkers of frailty and biological ageing in the emergency setting.
• Biomarkers for delirium detection, risk stratification, and monitoring.
• Biomarkers relevant to multimorbidity and polypharmacy.
• Biomarkers to support critical illness recognition and triage in older adults.
• Biomarkers to inform end-of-life and goals-of-care decision-making.
• Novel biomarker platforms, panels, or point-of-care technologies applicable to emergency geriatric care.
• Integration of biomarkers with clinical assessment tools and risk scores.
• Implementation, feasibility, and health-economic considerations of biomarker use in emergency settings.

Who Should Submit

We invite submissions from researchers and clinicians across emergency medicine, geriatric medicine, clinical biochemistry, gerontology, nursing, and related fields. Both established investigators and early-career researchers are encouraged to contribute.