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...

Descripción completa

Detalles Bibliográficos
Autores: 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
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p16270
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/16270
Access Level:acceso abierto
Palabra clave:Emergencies
Geriatrics
Frail elderly
Triage
id ES_05bcdb911e01bad0bd42e0c8aefbe9d5
oai_identifier_str oai:fisabio.fundanetsuite.com:p16270
network_acronym_str ES
network_name_str España
repository_id_str
spelling Older Adult Patients in the Emergency Department: Which Patients should be Selected for a Different Approach?Aguirre NLGutiérrez SGMiro OAguiló SJacob JAlquézar-Arbé ABurillo GFernandez CLlorens PAlonso CRLopez ITCañete MAsensio PRDíaz BPPizarro TPNavarro RJDRViola NPHernández-Castells LSoler ACSánchez Fernández-Linares ESerrano JÁSEzponda PLorenzo AMLiarte JVORamón SSAranda ARMartín-Sánchez FJDel Castillo JGEmergenciesGeriatricsFrail elderlyTriageBackground: 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 SOC2024info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fisabio.portalinvestigacion.com/publicaciones/16270Annals of Geriatric Medicine and ResearchISSN: 25084909ISSNl: 25084798reponame:r-FISABIO. Repositorio Institucional de Producción Científicainstname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)Inglésinfo:eu-repo/semantics/openAccessoai:fisabio.fundanetsuite.com:p162702026-06-11T12:45:17Z
dc.title.none.fl_str_mv Older Adult Patients in the Emergency Department: Which Patients should be Selected for a Different Approach?
title Older Adult Patients in the Emergency Department: Which Patients should be Selected for a Different Approach?
spellingShingle Older Adult Patients in the Emergency Department: Which Patients should be Selected for a Different Approach?
Aguirre NL
Emergencies
Geriatrics
Frail elderly
Triage
title_short 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_sort Older Adult Patients in the Emergency Department: Which Patients should be Selected for a Different Approach?
dc.creator.none.fl_str_mv 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 Aguirre NL
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
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
dc.subject.none.fl_str_mv Emergencies
Geriatrics
Frail elderly
Triage
topic Emergencies
Geriatrics
Frail elderly
Triage
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.
publishDate 2024
dc.date.none.fl_str_mv 2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fisabio.portalinvestigacion.com/publicaciones/16270
url https://fisabio.portalinvestigacion.com/publicaciones/16270
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv KOREAN GERIATRIC SOC
publisher.none.fl_str_mv KOREAN GERIATRIC SOC
dc.source.none.fl_str_mv Annals of Geriatric Medicine and Research
ISSN: 25084909
ISSNl: 25084798
reponame:r-FISABIO. Repositorio Institucional de Producción Científica
instname: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)
reponame_str r-FISABIO. Repositorio Institucional de Producción Científica
collection r-FISABIO. Repositorio Institucional de Producción Científica
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869402874020102144
score 15,812455

Similares en LA Referencia