Elderly 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...

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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
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Recursos:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
Repositorio:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
OAI Identifier:oai:isabial.fundanetsuite.com:p9986
Acesso em linha:https://isabial.portalinvestigacion.com/publicaciones9986
https://www.e-agmr.org/journal/view.php?doi=10.4235/agmr.23.0121
Access Level:acceso abierto
Palavra-chave:Emergencies
Frail Older adult
Geriatrics
Triage
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spelling Elderly 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 JGEmergenciesFrail Older adultGeriatricsTriageBACKGROUND: 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 d. 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 [SD 8.1] years, 12,626 (54.1%) women). During follow-up, 5,776 (24.75) patients 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 d after discharge following the index visit. A model including male sex, age =75 years, arrival by ambulance, Charlson Cormorbidity Index =3, and functional impairment had a C-index of 0.81 (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://isabial.portalinvestigacion.com/publicaciones9986https://www.e-agmr.org/journal/view.php?doi=10.4235/agmr.23.0121Annals of Geriatric Medicine and ResearchISSN: 25084909ISSNl: 25084798reponame:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicanteinstname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)Inglésinfo:eu-repo/semantics/openAccessoai:isabial.fundanetsuite.com:p99862026-06-12T10:20:37Z
dc.title.none.fl_str_mv Elderly patients in the Emergency Department: Which patients should be selected for a different approach?
title Elderly patients in the Emergency Department: Which patients should be selected for a different approach?
spellingShingle Elderly patients in the Emergency Department: Which patients should be selected for a different approach?
Aguirre NL
Emergencies
Frail Older adult
Geriatrics
Triage
title_short Elderly patients in the Emergency Department: Which patients should be selected for a different approach?
title_full Elderly patients in the Emergency Department: Which patients should be selected for a different approach?
title_fullStr Elderly patients in the Emergency Department: Which patients should be selected for a different approach?
title_full_unstemmed Elderly patients in the Emergency Department: Which patients should be selected for a different approach?
title_sort Elderly 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
Frail Older adult
Geriatrics
Triage
topic Emergencies
Frail Older adult
Geriatrics
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 d. 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 [SD 8.1] years, 12,626 (54.1%) women). During follow-up, 5,776 (24.75) patients 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 d after discharge following the index visit. A model including male sex, age =75 years, arrival by ambulance, Charlson Cormorbidity Index =3, and functional impairment had a C-index of 0.81 (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://isabial.portalinvestigacion.com/publicaciones9986
https://www.e-agmr.org/journal/view.php?doi=10.4235/agmr.23.0121
url https://isabial.portalinvestigacion.com/publicaciones9986
https://www.e-agmr.org/journal/view.php?doi=10.4235/agmr.23.0121
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-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
instname:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
instname_str Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
reponame_str r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
collection r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812455

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