Factors influencing the presentation and care of elderly people in the Emergency Department

Stathers, George M.; Delpech, Valérie; Raftos, John

doi:10.5694/j.1326-5377.1992.tb139707.x

Cited by 27 publications

(22 citation statements)

References 6 publications

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“…10 No Australian report has been published specifically about patients in this age group presenting to the emergency department (ED) after falls, although previous studies have looked at older people presenting to the ED. 11,12 Our aim was therefore to focus on patients over 65 years who presented to our ED as a result of a fall. Several…”

supporting

confidence: 87%

Characteristics and outcomes of older patients presenting to the emergency department after a fall: a retrospective analysis

Bell

Talbot-Stern²,

Hennessy³

2000

Medical Journal of Australia

120

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Objectives To study older patients presenting to the emergency department after a fall ‐ factors associated with the fall, injuries sustained and outcome. Design A retrospective analysis using the Emergency Department Information System (EDIS), the Trauma Registry and the patient information database (CCIS), in addition to the patient's emergency and inpatient medical records. Setting Emergency department of a major inner city teaching hospital, 1 June ‐ 30 November 1997. Patients All patients over 65 years presenting to the emergency department (ED) after a fall, for whom complete medical records were available. Results Of 803 patients over 65 years presenting to the ED after a fall, complete records were available for 733 (91.3%) (283 men and 450 women). Extrinsic (accidental) causes were implicated in more than a third of falls (313 patients [42.7%]). A high proportion of the patients were living at home (520; 70.9%) and walking unaided (389; 53.1%). Although absolute numbers of women increased with age, men were as likely as women to present after a fall. Many patients had fallen before ‐ 39% of the men (111/283) and 24% of the women (110/450). In 78 patients (10.6%), alcohol misuse may have been a direct cause of the fall. The overall injury rate was 70.5% (517/733 patients), the most common injury being an isolated fracture (269/517 patients; 52.0%). In all, 419 patients (57.2%) were admitted to hospital, 48% (200/419) with a fracture and 52% (219/419) for investigation of the medical cause of the fall. The median length of hospital stay was 6 days (mean, 10.4 days; range, 1‐129 days); 35% (146/419) of patients were in hospital for more than 10 days. Conclusion Older patients presenting to the ED after a fall had high injury rates, high admission rates and often prolonged hospitalisation. About a third had fallen before. Patients at risk can be identified in the ED and referred to falls prevention programs.

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supporting

confidence: 87%

Characteristics and outcomes of older patients presenting to the emergency department after a fall: a retrospective analysis

Bell

Talbot-Stern²,

Hennessy³

2000

Medical Journal of Australia

120

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“…It has been reported that unnecessary ambulance use is related to socioeconomic factors [18-24]. However, there have been few studies of how socioeconomic factors influence a person's decision to call an ambulance [28].…”

Section: Discussionmentioning

confidence: 99%

“…The problem of inappropriate ambulance use has been reported worldwide [18-24]. Brown et al [23] reported that inappropriate ambulance use accounts for 40% to 50% of total ambulance use in the United States, Canada, Sweden, and England.…”

Section: Introductionmentioning

confidence: 99%

Influence of socioeconomic factors on medically unnecessary ambulance calls

Kawakami

Ohshige

Kubota

et al. 2007

BMC Health Serv Res

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“…Older patients will consider the ED as their "first port of call" when they are ill, as they perceive that a fully-equipped medical institution is more likely to cater to their complex needs. 16 A study in a French hospital confirmed that the ED is considered an important point of access to better facilities and care. 17 However, there is growing evidence that a continuous relationship between older adult patients and their primary care physicians was able to reduce the attendance to ED.…”

Section: Discussionmentioning

confidence: 99%

“…There are nine government‐funded health clinics in the hospital catchment area, but the strategic position of the university hospital means that many find the hospital more accessible than the local health clinics. Older patients will consider the ED as their “first port of call” when they are ill, as they perceive that a fully‐equipped medical institution is more likely to cater to their complex needs . A study in a French hospital confirmed that the ED is considered an important point of access to better facilities and care .…”

Section: Discussionmentioning

confidence: 99%

Utilization of the emergency department by older residents in Kuala Lumpur, Malaysia

Mokhtar

Zakaria

et al. 2014

Geriatrics Gerontology Int

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The ratio of older adult patients attending our ED over the proportion of older people in the general population was 26:6, which is far higher than reported in previous published studies carried out in other countries. Older ED attenders are also more likely to require investigations, procedures and hospital admissions. With the rapidly aging population in Malaysia, reconfiguration of resources will need to occur at a compatible rate in order to ensure that the healthcare needs of our older adults are met.

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Factors influencing the presentation and care of elderly people in the Emergency Department

Cited by 27 publications

References 6 publications

Characteristics and outcomes of older patients presenting to the emergency department after a fall: a retrospective analysis

Characteristics and outcomes of older patients presenting to the emergency department after a fall: a retrospective analysis

Influence of socioeconomic factors on medically unnecessary ambulance calls

Utilization of the emergency department by older residents in Kuala Lumpur, Malaysia

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