Examinando por Autor "Larrea, Nere"

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    Older adult patients in the emergency department: which patients should be selected for a different approach?
    (Korean Geriatrics Society, 2024-03) Larrea, Nere; García Gutiérrez, Susana; Miró Andreu, Óscar; Aguiló, Sira; Jacob Rodríguez, Javier; Alquézar, Aitor; Burillo Putze, Guillermo; Fernández Alonso, Cesáreo; Llorens Soriano, Pere; Roza Alonso, César; Tavasci López, Ivana Verónica; Cañete, Mónica; Ruiz Asensio, Pedro; Paderne Díaz, Beatriz; Pablos Pizarro, Teresa; Rio Navarro, Rigoberto Jesús del; Perelló Viola, Nuria; Hernández Castells, Lourdes; Cortés Soler, Alejandro; Sánchez Fernández-Linares, Elena; Sánchez Serrano, Jesús Ángel; Ezponda, Patxi; Martínez Lorenzo, Andrea; Ortega Liarte, Juan Vicente; Sánchez Ramón, Susana; Ruiz Aranda, Asumpta; Martín Sánchez, Francisco Javier; González del Castillo, Juan
    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.