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Aguirre, Nere Larrea; Gutiérrez, Susana García; Miro, Oscar; Aguiló, Sira; Jacob, Javier; Alquézar-Arbé, Aitor; Burillo, Guillermo; Fernandez, Cesáreo; Llorens, Pere; Alonso, Cesar Roza; Lopez, Ivana Tavasci; Cañete, Mónica; Asensio, Pedro Ruiz; Díaz, Beatriz Paderne; Pizarro, Teresa Pablos; Navarro, Rigoberto Jesús Del Rio; Viola, Núria Perelló; Hernández-Castells, Lourdes; Soler, Alejandro Cortés; Sánchez Fernández-Linares, Elena; Serrano, Jesús Ángel Sánchez; Ezponda, Patxi; Lorenzo, Andrea Martínez; Liarte, Juan Vicente Ortega; Ramón, Susana Sánchez; Aranda, Asumpta Ruiz; Martín-Sánchez, Francisco Javier; Del Castillo, Juan González
Annals of geriatric medicine and research, 03/2024, Letnik: 28, Številka: 1Journal Article
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. 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. 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. 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.
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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Vir: Osebne bibliografije
in: SICRIS
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