Impact of the COVID-19 pandemic on demand for emergency department care for older patients: the EDEN-7 COVID cohort study

Objective. To analyze the impact of the COVID-19 pandemic on Spanish emergency department (ED) care for patients aged 65 years or older during the first wave vs. a pre-pandemic period. Methods. Retrospective cross-sectional study of a COVID-19 portion of the EDEN project (Emergency Department and El...

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Autores: Montero-Pérez FJ, Cobos Requena ÁM, González Del Castillo J, Jacob J, García-Lamberechts EJ, Piñera Salmerón P, Alquézar-Arbé A, Aguiló S, Fernández Alonso C, Burillo-Putze G, Calderón Caro M, Díaz Salado ÁI, Martín Mojarro E, Eiroa-Hernández P, Parra-Esquivel P, López Pérez JJ, Ruiz Grinspan M, Osorio Quispe IG, González Tejera M, Serrano Lázaro L, Espinosa Fernández B, Fuentes L, Suero Méndez C, Del Valle Toro-Gallardo M, Beddar Chaib F, Pedraza Ramírez P, Miró Ò
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
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:p15534
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/15534
Access Level:acceso abierto
Palabra clave:Emergency department
Geriatrics
COVID-19
Descripción
Sumario:Objective. To analyze the impact of the COVID-19 pandemic on Spanish emergency department (ED) care for patients aged 65 years or older during the first wave vs. a pre-pandemic period. Methods. Retrospective cross-sectional study of a COVID-19 portion of the EDEN project (Emergency Department and Elder Needs). The EDEN-COVID cohort included all patients aged 65 years or more who were treated in 52 EDs on 7 consecutive days early in the pandemic. We analyzed care variables, discharge diagnoses, use of diagnostic and therapeutic resources, use of observation units, need for hospitalization, rehospitalization, and mortality. These data were compared with data for an EDEN cohort in the same age group recruited during a similar period the year before the pandemic. Results. The 52 participating hospital EDs attended 33 711 emergencies during the pandemic vs. 96 173 emergencies in the pre-COVID period, representing a 61.7% reduction during the pandemic. Patients aged 65 years or older accounted for 28.8% of the caseload during the COVID-19 period and 26.4% of the earlier cohort (P <.001). The COVID- 19 caseload included more men (51.0%). Comorbidity and polypharmacy were more prevalent in the pandemic cohort than in the earlier one (comorbidity, 92.6% vs. 91.6%; polypharmacy, 65.2% vs. 63.6%). More resources (analgesics, antibiotics, heparins, bronchodilators, and corticosteroids) were applied in the pandemic period, and common diagnoses were made less often. Observation wards were used more often (for 37.8% vs. 26.2% in the earlier period), and hospital admissions were more frequent (in 56.0% vs. 25.3% before the pandemic). Mortality was higher during the pandemic than in the earlier cohort either in ED (1.8% vs 0.5%) and during hospitalization (11.5 vs 2.9%). Conclusions. The proportion of patients aged 65 years or older decreased in the participating Spanish EDs. However, more resources were required and the pattern of diagnoses changed. Observation ward stays were longer, and admissions and mortality increased over the numbers seen in the reference period.

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