Pattern of use and presenting complaints of older patients visiting an Emergency Department in Italy

Salvi, F.; Mattioli, Annalisa; Giannini, Elena; Vita, Diego; Morichi, Valeria; Fallani, M; Dessı̀-Fulgheri, Paolo; Cherubini, Antonio

doi:10.1007/s40520-013-0112-z

Cited by 26 publications

(29 citation statements)

References 36 publications

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“…Furthermore, in Singapore, a study conducted by Foo et al 19 reported that falls were the most common complaint among elderly patients, which increased their odds of getting admitted compared to the control group (OR: 1.9; 95% CI: 1.4–2.6), and a similar report from the Italy revealed that older trauma patients have high odds (OR: 5.12, 95% CI: 3.34–7.85) 20 . In the present study, the most common diseases and complaints in elderly patients were URTI (17.5%, CI: 17.1–17.9), chest pain (14.5%, 95% CI: 14.2–14.9), injury (11.7%, 95% CI: 11.4–12.1), myalgia (8.9%, 95% CI: 8.6–9.2), and LRTI (7.1%, 95% CI: 6.8–7.4).…”

Section: Discussionmentioning

confidence: 89%

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The ED use and non-urgent visits of elderly patients

Gülaçtı

Lök

Çelik

et al. 2016

Turkish Journal of Emergency Medicine

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ObjectiveTo evaluate the use of the emergency department (ED) by elderly patients, their non-urgent visits and the prevalence of main disease for ED visits.MethodsThis cross-sectional study was conducted on patients aged 65 years and over who visited the ED of a tertiary care university hospital in Turkey between January 2015 and January 2016 retrospectively.ResultsA total of 36,369 elderly patients who visited the ED were included in the study. The rate of ED visits by elderly patients was higher than their representation within the general population (p < 0.001). While the rate of elderly patients visiting polyclinics was 15.8%, the rate of elderly patients visiting the ED was 24.3% (p < 0.001). For both genders, the rates of ED visits for patients between 65 and 74 years old was higher than for other elderly age groups (p < 0.001). The prevalence of upper respiratory tract infection (URTI) was the highest within the elderly population (17.5%, CI: 17.1–17.9). The proportion of ED visits for non-urgent conditions was 23.4%. Most of the ED visits were during the non-business hours (51.1%), and they were highest in the winter season (25.9%) and in January (10.2%). The hospitalization rate was 9.4%, and 37.9% of hospitalized patients were admitted to intensive care units.ConclusionThe proportion of ED visits by elderly patients was higher than their representation within the general population. Elderly patients often visited the ED instead of a polyclinic. The rate of inappropriate ED use by elderly patients in this hospital was higher than in other countries.

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Section: Discussionmentioning

confidence: 89%

“…A study by Yim et al 24 found that the total proportion of non-urgent visits in three Hong Kong EDs was less than 5%. Another study by Salvi et al 20 on older patients visiting the ED in Italy reported that the proportion of non-urgent visits was 3%. However, the present study found this rate to be much higher (23.4%).…”

Section: Discussionmentioning

confidence: 97%

The ED use and non-urgent visits of elderly patients

Gülaçtı

Lök

Çelik

et al. 2016

Turkish Journal of Emergency Medicine

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“…27 Even in countries with greater healthcare utilization amongst men, there is a marked female predominance in the oldest ED patients. 28,29,30 In this study there were more women in all age-groups, with the exception of young-older adults. There was an increased chance of admission for men in all age categories, except in the old-older group, where the probability of admission was similar to women.…”

Section: Discussionmentioning

confidence: 49%

The growing impact of older patients in the Emergency Department: a 5-year retrospective analysis in Brazil

Gomes

Dias

Barros

et al. 2020

Preprint

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Background: The average age of the global population is rising at an increasing rate. There is a disproportional increase in Emergency Department (ED) visits by older people worldwide. In the Brazilian health system, complex and severely ill patients and those requiring specialized urgent procedures are referred to tertiary level care. As far as we know, no other study in Latin America has analyzed the impact of demographic changes in tertiary ED attendance. Aim: To describe the sociodemographic characteristics and outcomes of tertiary Brazilian ED users. Methods: Design: Observational cross-sectional analytic study. Setting: Emergency Department, tertiary university hospital, São Paulo, Brazil. Participants: patients aged 18 years or older attending a tertiary ED (2009-2013). The primary outcomes were hospitalization and mortality; the secondary outcome was ICU admission. Age was categorized as ‘young adults’ (18-39y), ‘adults’ (40-59y), ‘young-older adults’ (60-79y), and ‘old-older adults’ (80-109y). Other variables included sex, reason for attendance, time of ED visit, mode of presentation, type of hospitalization, main procedure, length of hospital stay (LOS) and length of ICU stay (ICU-LOS). We calculated descriptive statistics, built generalized linear mixed models for each outcome and estimated Odds Ratios (95% CI) for the independent categorical variables. The significance level was 5% with Bonferroni correction. Results: Older age-groups represented 26.6% of 333,028 ED visits, 40.7% of admissions, 42.7% of ICU admissions and 58% of all deaths. Old-older patients accounted for 5.1% of ED visits, 9.5% of admissions and 10.1% of ICU admissions. Hospitalization, ICU admission and mortality rates increased with older age in both sexes. LOS and ICU-LOS were similar across age-groups. The proportions of visits and admissions attributed to young adults decreased annually, while those of people aged 60 or over increased. The ORs for hospitalization, ICU admission and mortality associated with the old-older group were 3.49 (95% CI = 3.15-3.87), 1.27 (1.15-1.39) and 5.93 (5.29-6.66) respectively, with young adults as the reference. Conclusions: In tertiary ED, age is an important risk factor for hospitalization and mortality, but not for ICU admission. Old-older people are at the greatest risk and demand further subgroup stratification.

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“…Their top diagnoses were "symptoms, signs, and ill-defined conditions" (25%) and "injury and poisoning" (17%). Salvi et al [15] also reported their findings in Italy that dyspnea and abdominal pain were the most frequent nontrauma presenting complains among geriatric patients and represented the main causes for admission. These are similar to our fi ndings.…”

Section: Discussionmentioning

confidence: 88%

Utilization of the Accident & Emergency Departments by Chinese elderly in Hong Kong

Yip

Fan

Lui

et al. 2015

World Journal of Emergency Medicine

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Pattern of use and presenting complaints of older patients visiting an Emergency Department in Italy

Abstract: Older adults use the ED appropriately also in Italy. Trauma with complications (fracture) and various presenting complaints underlying medical problems accounted for more than 50 % of ED visits and hospital admissions.

Cited by 26 publications

References 36 publications

The ED use and non-urgent visits of elderly patients

The ED use and non-urgent visits of elderly patients

The growing impact of older patients in the Emergency Department: a 5-year retrospective analysis in Brazil

Utilization of the Accident & Emergency Departments by Chinese elderly in Hong Kong

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