Use of emergency departments by elderly patients: Projections from a multicenter data base

Strange, Gary R.; Chen, Edwin H.; Sanders, Arthur B.

doi:10.1016/s0196-0644(05)81028-5

Cited by 190 publications

(125 citation statements)

References 11 publications

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“…1 Numerous studies have found that older adults use emergency services more frequently and have higher hospital admission rates (>65%) than younger persons. [2][3][4][5] Older patients undergo more frequent diagnostic testing than younger patients, and have longer lengths of stay (LOS) in hospital with an increased rate of adverse outcomes.…”

Section: Introductionmentioning

confidence: 99%

Common Diagnoses and Outcomes in Elderly Patients Who Present to the Emergency Department with Non-Specific Complaints

Quinn

Herman

Lin

et al. 2015

CJEM

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Objective: Elderly patients often present to the emergency department (ED) with non-specific complaints. Previous studies indicate that such patients are at greater risk for lifethreatening illnesses than similarly aged patients with specific complaints. We evaluated the diagnoses and outcomes of elderly patients presenting with non-specific complaints. Methods: Two trained data abstractors independently reviewed all records of patients over 70 years old presenting (to two academic EDs) with non-specific complaints, as defined by the Canadian Emergency Department Information System (CEDIS). Outcomes of interest were ED discharge diagnosis, hospital admission, length of stay, and ED revisit within 30 days. Results: Of the 743 patients screened for the study, 265 were excluded because they had dizziness, vertigo, or a specific complaint recorded in the triage notes. 419 patients (87.7%) presented with weakness and 59 patients (12.3%) presented with general fatigue or unwellness. The most common diagnoses were urinary tract infection (UTI) (11.3%), transient ischemic attack (TIA) (10.0%), and dehydration (5.6%). There were 11 hospital admissions with median length of stay of five days. Eighty-one (16.9%) patients revisited the ED within 30 days of discharge. Regression analysis indicated that arrival to the ED by ambulance was independently associated with hospital admission. Conclusions: Our results suggest that elderly patients presenting to the ED with non-specific complaints are not at high risk for life-threatening illnesses. The most common diagnoses are UTI, TIA, and dehydration. Most patients can be discharged safely, although a relatively high proportion revisit the ED within 30 days. RÉSUMÉObjectif: Il est fréquent que des personnes âgées consultent au service des urgences (SU) pour des symptômes généraux. D'après des études antérieures, ces patients connaissent un risque plus grand de maladies potentiellement mortelles que les patients de même âge ayant des symptômes précis. Aussi les auteurs ont-ils évalué les diagnostics posés chez des personnes âgées examinées pour des symptômes généraux, de même que l'issue. Méthode: Deux personnes formées à l'abstraction de données ont examiné, chacune de leur côté, tous les dossiers de patients âgés de plus de 70 ans, qui ont consulté dans deux SU d'hôpitaux universitaires pour des symptômes généraux tels qu'ils sont définis dans le Canadian Emergency Department Information System (CEDIS). Les principaux critères d'évaluation comprenaient le diagnostic au moment du congé du SU, l'hospitalisation, la durée de séjour et les nouvelles consultations au SU dans les 30 jours suivants. Résultats: Sur 743 patients présélectionnés pour l'étude, 265 ont été écartés parce qu'on faisait déjà mention d'« étourdis-sements » ou de « vertiges » ou encore de symptômes précis dans les notes relatives au triage. Sur le nombre restant de patients, 419 (87,7 %) présentaient de la faiblesse, et 59 (12,3 %), de la fatigue générale ou un état de malaise. Les diagnostics les plus f...

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Section: Introductionmentioning

confidence: 99%

Common Diagnoses and Outcomes in Elderly Patients Who Present to the Emergency Department with Non-Specific Complaints

Quinn

Herman

Lin

et al. 2015

CJEM

View full text Add to dashboard Cite

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“…In addition, most countries are experiencing a rapid increase in the number of elder patients, who require emergency health care services at higher rates than younger patients. [5][6][7] Many EM practitioners in well-established EM systems believe that the system of clinical care they provide results in improved public health and greater efficiency of patient care. However, there is limited published scientific evidence supporting these contentions.…”

Section: Background and Development Goalsmentioning

confidence: 99%

Planning Recommendations for International Emergency Medicine and Out‐of‐hospital Care System Development

Holliman

VanRooyen

Green

et al. 2000

Academic Emergency Medicine

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Abstract.Objectives: To present suggestions on planning for development of emergency medicine (EM) and out-of-hospital care in countries that are in an early phase of this process, and to provide basic background information for planners not already familiar with EM. Methods: The techniques and programs used by the authors and others in assisting in EM development in other countries to date are described. Conclusions: Some aspects of EM system development have applicability to most countries, but other aspects must be decided by planners based on country-specific factors. Because of the very recent initiation of many EM system development efforts in other countries, to the authors' knowledge there have not yet been extensive evaluative reports of the efficacy of these efforts. Further studies are needed on the relative effectiveness and cost-benefit of different EM development efforts. Key words: emergency medicine development; international emergency medicine; system development; EMS systems. ACA-DEMIC EMERGENCY MEDICINE 2000; 7:911-917 T HE specialty of emergency medicine (EM) is only now beginning to develop in a number of countries throughout the world, and in fact is a relatively new specialty even in countries where it is currently well established. For countries considering developing EM and for those just starting this process, to our knowledge there have not been previously published planning recommendations The goal of this article is to present general recommendations for development planning for the specialty of EM 1 that would be applicable to any country considering, or having already started, this specialty. We suggest sequential steps that can be considered by planners interested in developing EM and out-of-hospital care [or emergency medical services (EMS) systems] within any country. Our intended audience includes policy makers, government officials, and educators who may not necessarily already be familiar with EM as a specialty.Our suggestions are based on our collective experience involving assistance with EM system development in more than 20 countries. We acknowledge and emphasize that the content of this article is based solely on our experience, and the results of our development efforts to date have not been validated by published research studies. However, we hope that this paper will be useful in assisting and facilitating EM development in other countries and make the initial process easier and quicker for those involved. We also hope that this article will help planners avoid some of the mistakes and pitfalls that occurred during EM development in INTERNATIONAL EMHolliman et al.• EM DEVELOPMENT RECOMMENDATIONS countries where the specialty is now well established. Our interest in EM system development stems from a desire to promote optimum emergency patient care and quality EM clinical training programs, and not from a desire to promote any particular medical or cultural system. Not all of the features or considerations mentioned here will be applicable to, or adoptable by, all c...

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“…4 Our findings may be more accurate because they are based on actual emergency department bills as opposed to patient recall or convenience samples. [26][27][28] The elderly appear to make more emergency department visits than younger adults. In Selby et al's study of patients 63 years and younger, patients aged 45 to 63 years in the control groups made between 158 and 194 visits per 1000 patient-years.…”

Section: Epidemiology Of Emergency Department Use Among the Elderlymentioning

confidence: 99%

The effect of the doctor-patient relationship on emergency department use among the elderly

et al. 2000

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Use of emergency departments by elderly patients: Projections from a multicenter data base

Cited by 190 publications

References 11 publications

Common Diagnoses and Outcomes in Elderly Patients Who Present to the Emergency Department with Non-Specific Complaints

Common Diagnoses and Outcomes in Elderly Patients Who Present to the Emergency Department with Non-Specific Complaints

Planning Recommendations for International Emergency Medicine and Out‐of‐hospital Care System Development

The effect of the doctor-patient relationship on emergency department use among the elderly

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