Older Adult Patients in the Emergency Department: Which Patients should be Selected for a Different Approach?
Background: While multidimensional and interdisciplinary assessment of older adult patients improves their short-term outcomes after evaluation in the emergency department (ED), this assessment is time-consuming and ill-suited for the busy environment. Thus, identifying patients who will benefit fro...
| Authors: | ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; |
|---|---|
| Format: | Article |
| Status: | Published version |
| Publication date: | 2024 |
| Country: | España |
| Institution: | Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO) |
| Repository: | r-FISABIO. Repositorio Institucional de Producción Científica |
| OAI Identifier: | oai:fisabio.fundanetsuite.com:p16270 |
| Online Access: | https://fisabio.portalinvestigacion.com/publicaciones/16270 |
| Access Level: | Open access |
| Keyword: | Emergencies Geriatrics Frail elderly Triage |
| _version_ | 1878729326424227840 |
|---|---|
| author | Aguirre NL |
| author2 | Gutiérrez SG Miro O Aguiló S Jacob J Alquézar-Arbé A Burillo G Fernandez C Llorens P Alonso CR Lopez IT Cañete M Asensio PR Díaz BP Pizarro TP Navarro RJDR Viola NP Hernández-Castells L Soler AC Sánchez Fernández-Linares E Serrano JÁS Ezponda P Lorenzo AM Liarte JVO Ramón SS Aranda AR Martín-Sánchez FJ Del Castillo JG |
| author2_role | author author author author author author author author author author author author author author author author author author author author author author author author author author author |
| author_browse | Aguiló S Aguirre NL Alonso CR Alquézar-Arbé A Aranda AR Asensio PR Burillo G Cañete M Del Castillo JG Díaz BP Ezponda P Fernandez C Gutiérrez SG Hernández-Castells L Jacob J Liarte JVO Llorens P Lopez IT Lorenzo AM Martín-Sánchez FJ Miro O Navarro RJDR Pizarro TP Ramón SS Serrano JÁS Soler AC Sánchez Fernández-Linares E Viola NP |
| author_facet | Aguirre NL Gutiérrez SG Miro O Aguiló S Jacob J Alquézar-Arbé A Burillo G Fernandez C Llorens P Alonso CR Lopez IT Cañete M Asensio PR Díaz BP Pizarro TP Navarro RJDR Viola NP Hernández-Castells L Soler AC Sánchez Fernández-Linares E Serrano JÁS Ezponda P Lorenzo AM Liarte JVO Ramón SS Aranda AR Martín-Sánchez FJ Del Castillo JG |
| author_role | author |
| collection | r-FISABIO. Repositorio Institucional de Producción Científica |
| description | Background: While multidimensional and interdisciplinary assessment of older adult patients improves their short-term outcomes after evaluation in the emergency department (ED), this assessment is time-consuming and ill-suited for the busy environment. Thus, identifying patients who will benefit from this strategy is challenging. Therefore, this study aimed to identify older adult patients suitable for a different ED approach as well as independent variables associated with poor short-term clinical outcomes. Methods: We included all patients >= 65 years attending 52 EDs in Spain over 7 days. Sociodemographic, comorbidity, and baseline functional status data were collected. The outcomes were 30 -day mortality, re -presentation, hospital readmission, and the composite of all outcomes. Results: During the study among 96,014 patients evaluated in the ED, we included 23,338 patients >= 65 years-mean age, 78.4 +/- 8.1 years; 12,626 (54.1%) women. During follow-up, 5,776 patients (24.75%) had poor outcomes after evaluation in the ED: 1,140 (4.88%) died, 4,640 (20.51) returned to the ED, and 1,739 (7.69%) were readmitted 30 days after discharge following the index visit. A model including male sex, age >= 75 years, arrival by ambulance, Charlson Comorbidity Index >= 3, and functional impairment had a C -index of 0.81 (95% confidence interval, 0.80-0.82) for 30 -day mortality. Conclusion: Male sex, age >= 75 years, arrival by ambulance, functional impairment, or severe comorbidity are features of patients who could benefit from approaches in the ED different from the common triage to improve the poor short-term outcomes of this population. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | ES_05bcdb911e01bad0bd42e0c8aefbe9d5 |
| institution | Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO) |
| instname_str | Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO) |
| network_acronym_str | ES |
| network_name_str | España |
| oai_identifier_str | oai:fisabio.fundanetsuite.com:p16270 |
| publishDate | 2024 |
| publishDateSort | 2024 |
| publisher | KOREAN GERIATRIC SOC |
| publisherStr | KOREAN GERIATRIC SOC |
| reponame_str | r-FISABIO. Repositorio Institucional de Producción Científica |
| spelling | Older Adult Patients in the Emergency Department: Which Patients should be Selected for a Different Approach? Aguirre NL Gutiérrez SG Miro O Aguiló S Jacob J Alquézar-Arbé A Burillo G Fernandez C Llorens P Alonso CR Lopez IT Cañete M Asensio PR Díaz BP Pizarro TP Navarro RJDR Viola NP Hernández-Castells L Soler AC Sánchez Fernández-Linares E Serrano JÁS Ezponda P Lorenzo AM Liarte JVO Ramón SS Aranda AR Martín-Sánchez FJ Del Castillo JG Emergencies Geriatrics Frail elderly Triage Background: While multidimensional and interdisciplinary assessment of older adult patients improves their short-term outcomes after evaluation in the emergency department (ED), this assessment is time-consuming and ill-suited for the busy environment. Thus, identifying patients who will benefit from this strategy is challenging. Therefore, this study aimed to identify older adult patients suitable for a different ED approach as well as independent variables associated with poor short-term clinical outcomes. Methods: We included all patients >= 65 years attending 52 EDs in Spain over 7 days. Sociodemographic, comorbidity, and baseline functional status data were collected. The outcomes were 30 -day mortality, re -presentation, hospital readmission, and the composite of all outcomes. Results: During the study among 96,014 patients evaluated in the ED, we included 23,338 patients >= 65 years-mean age, 78.4 +/- 8.1 years; 12,626 (54.1%) women. During follow-up, 5,776 patients (24.75%) had poor outcomes after evaluation in the ED: 1,140 (4.88%) died, 4,640 (20.51) returned to the ED, and 1,739 (7.69%) were readmitted 30 days after discharge following the index visit. A model including male sex, age >= 75 years, arrival by ambulance, Charlson Comorbidity Index >= 3, and functional impairment had a C -index of 0.81 (95% confidence interval, 0.80-0.82) for 30 -day mortality. Conclusion: Male sex, age >= 75 years, arrival by ambulance, functional impairment, or severe comorbidity are features of patients who could benefit from approaches in the ED different from the common triage to improve the poor short-term outcomes of this population. KOREAN GERIATRIC SOC https://fisabio.portalinvestigacion.com/publicaciones/16270 |
| spellingShingle | Older Adult Patients in the Emergency Department: Which Patients should be Selected for a Different Approach? Aguirre NL Emergencies Geriatrics Frail elderly Triage |
| status_str | publishedVersion |
| title | Older Adult Patients in the Emergency Department: Which Patients should be Selected for a Different Approach? |
| title_full | Older Adult Patients in the Emergency Department: Which Patients should be Selected for a Different Approach? |
| title_fullStr | Older Adult Patients in the Emergency Department: Which Patients should be Selected for a Different Approach? |
| title_full_unstemmed | Older Adult Patients in the Emergency Department: Which Patients should be Selected for a Different Approach? |
| title_short | Older Adult Patients in the Emergency Department: Which Patients should be Selected for a Different Approach? |
| title_sort | Older Adult Patients in the Emergency Department: Which Patients should be Selected for a Different Approach? |
| topic | Emergencies Geriatrics Frail elderly Triage |
| topic_facet | Emergencies Geriatrics Frail elderly Triage |
| url | https://fisabio.portalinvestigacion.com/publicaciones/16270 |