Older adult patients in the emergency department: which patients should be selected for a different approach?

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dc.contributor.authorLarrea, Nere
dc.contributor.authorGarcía Gutiérrez, Susana
dc.contributor.authorMiró Andreu, Óscar
dc.contributor.authorAguiló, Sira
dc.contributor.authorJacob Rodríguez, Javier
dc.contributor.authorAlquézar, Aitor
dc.contributor.authorBurillo Putze, Guillermo
dc.contributor.authorFernández Alonso, Cesáreo
dc.contributor.authorLlorens Soriano, Pere
dc.contributor.authorRoza Alonso, César
dc.contributor.authorTavasci López, Ivana Verónica
dc.contributor.authorCañete, Mónica
dc.contributor.authorRuiz Asensio, Pedro
dc.contributor.authorPaderne Díaz, Beatriz
dc.contributor.authorPablos Pizarro, Teresa
dc.contributor.authorRio Navarro, Rigoberto Jesús del
dc.contributor.authorPerelló Viola, Nuria
dc.contributor.authorHernández Castells, Lourdes
dc.contributor.authorCortés Soler, Alejandro
dc.contributor.authorSánchez Fernández-Linares, Elena
dc.contributor.authorSánchez Serrano, Jesús Ángel
dc.contributor.authorEzponda, Patxi
dc.contributor.authorMartínez Lorenzo, Andrea
dc.contributor.authorOrtega Liarte, Juan Vicente
dc.contributor.authorSánchez Ramón, Susana
dc.contributor.authorRuiz Aranda, Asumpta
dc.contributor.authorMartín Sánchez, Francisco Javier
dc.contributor.authorGonzález del Castillo, Juan
dc.date.accessioned2025-05-21T07:46:15Z
dc.date.available2025-05-21T07:46:15Z
dc.date.issued2024-03
dc.date.updated2025-05-21T07:46:15Z
dc.description.abstractBackground: 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.en
dc.identifier.citationAguirre, N. L., Gutiérrez, S. G., Miro, O., Aguiló, S., Jacob, J., Alquézar-Arbé, A., Burillo, G., Fernandez, C., Llorens, P., Alonso, C. R., Lopez, I. T., Cañete, M., Asensio, P. R., Díaz, B. P., Pizarro, T. P., Navarro, R. J. d. R., Viola, N. P., Hernández-Castells, L., Soler, A. C., et al. (2024). Older adult patients in the emergency department: which patients should be selected for a different approach? Annals of Geriatric Medicine and Research, 28(1), 9-19. https://doi.org/10.4235/AGMR.23.0121
dc.identifier.doi10.4235/AGMR.23.0121
dc.identifier.eissn2508-4909
dc.identifier.issn2508-4798
dc.identifier.urihttp://hdl.handle.net/20.500.14454/2796
dc.language.isoeng
dc.publisherKorean Geriatrics Society
dc.rights© 2024 by The Korean Geriatrics Society
dc.subject.otherEmergencies
dc.subject.otherFrail elderly
dc.subject.otherGeriatrics
dc.subject.otherTriage
dc.titleOlder adult patients in the emergency department: which patients should be selected for a different approach?en
dc.typejournal article
dcterms.accessRightsopen access
oaire.citation.endPage19
oaire.citation.issue1
oaire.citation.startPage9
oaire.citation.titleAnnals of Geriatric Medicine and Research
oaire.citation.volume28
oaire.licenseConditionhttps://creativecommons.org/licenses/by-nc/4.0/
oaire.versionVoR
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