Analysis of patient-related factors associated with post-discharge adverse events in older patients quickly discharged home after emergency department care with no complementary investigations

Background: To investigate factors associated with post-discharge adverse events in older patients discharged after emergency department (ED) care with no complementary investigations (CI)-blood test (BT), X-ray (XR) or both. Methods: We included patients >= 65 years who attended 52 Spanish EDs a...

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Authors: Burillo-Putze, G, Rodriguez-Cabrera, M, Parra-Esquivel, P, Alquézar, A, Fernández, C, Aguiló, S, Jacob, J, Montero-Pérez, FJ, García-Lamberechts, EJ, Piñera, P, Marinero-Noval, C, Paramas-Lopez, L, Rosendo-Mesino, D, Cuevas-Jiménez, L, Vaswani-Bolchand, A, Quesada-Martínez, MC, Díaz-Guerra, MLP, Amarilla-Molinas, CL, González-Tejera, M, Mansilla-Collado, J, Caballero-Martínez, M, Llopis, F, Zambrano-Serrano, L, Toro-Gallardo, V, Beddar-Chaib, F, Pedraza-Ramírez, P, González-del-Castillo, J, Miró, O
Format: article
Status:Published version
Publication Date:2025
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:p18408
Online Access:https://fisabio.portalinvestigacion.com/publicaciones/18408
Access Level:Open access
Keyword:Direct discharge
Emergency department
Older
Revisit
Hospitalization
Death
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repository_id_str
spelling Analysis of patient-related factors associated with post-discharge adverse events in older patients quickly discharged home after emergency department care with no complementary investigationsBurillo-Putze, GRodriguez-Cabrera, MParra-Esquivel, PAlquézar, AFernández, CAguiló, SJacob, JMontero-Pérez, FJGarcía-Lamberechts, EJPiñera, PMarinero-Noval, CParamas-Lopez, LRosendo-Mesino, DCuevas-Jiménez, LVaswani-Bolchand, AQuesada-Martínez, MCDíaz-Guerra, MLPAmarilla-Molinas, CLGonzález-Tejera, MMansilla-Collado, JCaballero-Martínez, MLlopis, FZambrano-Serrano, LToro-Gallardo, VBeddar-Chaib, FPedraza-Ramírez, PGonzález-del-Castillo, JMiró, ODirect dischargeEmergency departmentOlderRevisitHospitalizationDeathBackground: To investigate factors associated with post-discharge adverse events in older patients discharged after emergency department (ED) care with no complementary investigations (CI)-blood test (BT), X-ray (XR) or both. Methods: We included patients >= 65 years who attended 52 Spanish EDs and were discharged home in <= 12 hours from 01-07 April 2019. The outcomes assessed were post-discharge combined adverse event (CAE) (all-cause ED revisit, hospitalization or death) occurring within the next 30 days. We analyzed whether age, sex, comorbidity, functional capacity, ability to walk, previous falls, dementia, depression and polypharmacy were associated with outcomes, and whether these outcomes differed compared to discharged patients undergoing CI. Results: We identified 4976 patients (mean time in ED: 1.44 hours, 95% confidence interval (CI): 1.41-1.47) and 1048 (21.4%) presented a CAE, associated with increased comorbidity, decreased functional capacity and polypharmacy but not with age. Compared with patients discharged after CI and spending 3.08 (3.05-3.11) hours in the ED, the CAE of patients without CI did not significantly differ (1208 cases, 22.2%, adjusted Hazard ratio (HR): 1.032, 95% CI: 0.949-1.122). Performing BT and XR increased ED time by 2.07 (1.59-2.15) and 0.35 (0.31-0.40) hours, respectively, while the increase when ordering both investigations was 2.23 (2.17-2.31) hours. Conclusions: ED discharge of older patients without CI does not increase risk of post-discharge events or shorten the time in ED. Age is not related to the risk of post-discharge adverse events, but comorbid and dependent patients with polypharmacy should be cautiously considered for being at increased risk of adverse outcomes.MRE PRESS2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fisabio.portalinvestigacion.com/publicaciones/18408Signa VitaeISSN: 13345605ISSNe: 1845206Xreponame: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:p184082026-06-11T12:45:17Z
dc.title.none.fl_str_mv Analysis of patient-related factors associated with post-discharge adverse events in older patients quickly discharged home after emergency department care with no complementary investigations
title Analysis of patient-related factors associated with post-discharge adverse events in older patients quickly discharged home after emergency department care with no complementary investigations
spellingShingle Analysis of patient-related factors associated with post-discharge adverse events in older patients quickly discharged home after emergency department care with no complementary investigations
Burillo-Putze, G
Direct discharge
Emergency department
Older
Revisit
Hospitalization
Death
title_short Analysis of patient-related factors associated with post-discharge adverse events in older patients quickly discharged home after emergency department care with no complementary investigations
title_full Analysis of patient-related factors associated with post-discharge adverse events in older patients quickly discharged home after emergency department care with no complementary investigations
title_fullStr Analysis of patient-related factors associated with post-discharge adverse events in older patients quickly discharged home after emergency department care with no complementary investigations
title_full_unstemmed Analysis of patient-related factors associated with post-discharge adverse events in older patients quickly discharged home after emergency department care with no complementary investigations
title_sort Analysis of patient-related factors associated with post-discharge adverse events in older patients quickly discharged home after emergency department care with no complementary investigations
dc.creator.none.fl_str_mv Burillo-Putze, G
Rodriguez-Cabrera, M
Parra-Esquivel, P
Alquézar, A
Fernández, C
Aguiló, S
Jacob, J
Montero-Pérez, FJ
García-Lamberechts, EJ
Piñera, P
Marinero-Noval, C
Paramas-Lopez, L
Rosendo-Mesino, D
Cuevas-Jiménez, L
Vaswani-Bolchand, A
Quesada-Martínez, MC
Díaz-Guerra, MLP
Amarilla-Molinas, CL
González-Tejera, M
Mansilla-Collado, J
Caballero-Martínez, M
Llopis, F
Zambrano-Serrano, L
Toro-Gallardo, V
Beddar-Chaib, F
Pedraza-Ramírez, P
González-del-Castillo, J
Miró, O
author Burillo-Putze, G
author_facet Burillo-Putze, G
Rodriguez-Cabrera, M
Parra-Esquivel, P
Alquézar, A
Fernández, C
Aguiló, S
Jacob, J
Montero-Pérez, FJ
García-Lamberechts, EJ
Piñera, P
Marinero-Noval, C
Paramas-Lopez, L
Rosendo-Mesino, D
Cuevas-Jiménez, L
Vaswani-Bolchand, A
Quesada-Martínez, MC
Díaz-Guerra, MLP
Amarilla-Molinas, CL
González-Tejera, M
Mansilla-Collado, J
Caballero-Martínez, M
Llopis, F
Zambrano-Serrano, L
Toro-Gallardo, V
Beddar-Chaib, F
Pedraza-Ramírez, P
González-del-Castillo, J
Miró, O
author_role author
author2 Rodriguez-Cabrera, M
Parra-Esquivel, P
Alquézar, A
Fernández, C
Aguiló, S
Jacob, J
Montero-Pérez, FJ
García-Lamberechts, EJ
Piñera, P
Marinero-Noval, C
Paramas-Lopez, L
Rosendo-Mesino, D
Cuevas-Jiménez, L
Vaswani-Bolchand, A
Quesada-Martínez, MC
Díaz-Guerra, MLP
Amarilla-Molinas, CL
González-Tejera, M
Mansilla-Collado, J
Caballero-Martínez, M
Llopis, F
Zambrano-Serrano, L
Toro-Gallardo, V
Beddar-Chaib, F
Pedraza-Ramírez, P
González-del-Castillo, J
Miró, O
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 Direct discharge
Emergency department
Older
Revisit
Hospitalization
Death
topic Direct discharge
Emergency department
Older
Revisit
Hospitalization
Death
description Background: To investigate factors associated with post-discharge adverse events in older patients discharged after emergency department (ED) care with no complementary investigations (CI)-blood test (BT), X-ray (XR) or both. Methods: We included patients >= 65 years who attended 52 Spanish EDs and were discharged home in <= 12 hours from 01-07 April 2019. The outcomes assessed were post-discharge combined adverse event (CAE) (all-cause ED revisit, hospitalization or death) occurring within the next 30 days. We analyzed whether age, sex, comorbidity, functional capacity, ability to walk, previous falls, dementia, depression and polypharmacy were associated with outcomes, and whether these outcomes differed compared to discharged patients undergoing CI. Results: We identified 4976 patients (mean time in ED: 1.44 hours, 95% confidence interval (CI): 1.41-1.47) and 1048 (21.4%) presented a CAE, associated with increased comorbidity, decreased functional capacity and polypharmacy but not with age. Compared with patients discharged after CI and spending 3.08 (3.05-3.11) hours in the ED, the CAE of patients without CI did not significantly differ (1208 cases, 22.2%, adjusted Hazard ratio (HR): 1.032, 95% CI: 0.949-1.122). Performing BT and XR increased ED time by 2.07 (1.59-2.15) and 0.35 (0.31-0.40) hours, respectively, while the increase when ordering both investigations was 2.23 (2.17-2.31) hours. Conclusions: ED discharge of older patients without CI does not increase risk of post-discharge events or shorten the time in ED. Age is not related to the risk of post-discharge adverse events, but comorbid and dependent patients with polypharmacy should be cautiously considered for being at increased risk of adverse outcomes.
publishDate 2025
dc.date.none.fl_str_mv 2025
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/18408
url https://fisabio.portalinvestigacion.com/publicaciones/18408
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 MRE PRESS
publisher.none.fl_str_mv MRE PRESS
dc.source.none.fl_str_mv Signa Vitae
ISSN: 13345605
ISSNe: 1845206X
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_ 1869403722784702464
score 15.812429

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