Use of resources in elderly patients consulting the emergency department: analysis of the Emergency Department and Elder Needs Cohort (EDEN-21).

Autor: Fuentes E; Servicio de Urgencias, Hospital Universitari de Bellvitge, Universitat de Barcelona, IDIBELL, C/ Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain., Jacob J; Servicio de Urgencias, Hospital Universitari de Bellvitge, Universitat de Barcelona, IDIBELL, C/ Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain. jjacob@bellvitgehospital.cat., Del Castillo JG; Servicio de Urgencias, Hospital Clínico San Carlos, IDISSC, Universidad Complutense, Madrid, Spain., Montero-Pérez FJ; Servicio de Urgencias, Hospital Reina Sofía, Córdoba, Spain., Alquezar-Arbé A; Servicio de Urgencias, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain., García-Lamberechts EJ; Servicio de Urgencias, Hospital Clínico San Carlos, IDISSC, Universidad Complutense, Madrid, Spain., Aguiló S; Área de Urgencias, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain., Fernández-Alonso C; Servicio de Urgencias, Hospital Clínico San Carlos, IDISSC, Universidad Complutense, Madrid, Spain., Burillo-Putze G; Servicio de Urgencias, Hospital Universitario de Canarias, Tenerife, Spain., Piñera P; Servicio de Urgencias, Hospital Reina Sofía, Murcia, Spain., Llauger L; Servicio de Urgencias, Hospital de Vic, Barcelona, Spain., Vázquez-Rey V; Servicio de Urgencias, Hospital del Nalón, Langreo, Asturias, Spain., Carrasco-Fernández E; Servicio de Urgencias, Hospital Altagracia, Manzanares, Spain., Juárez R; Servicio de Urgencias, Hospital Nuestra Señora del Prado de Talavera de La Reina, Toledo, Spain., Blanco-Hoffman MJ; Servicio de Urgencias, Hospital Universitario Vinalopó, Elche, Spain., de Las Nieves Rodríguez E; Servicio de Urgencias, Hospital de Móstoles, Madrid, Spain., Rios-Gallardo R; Servicio de Urgencias, Hospital Virgen del Rocio, Seville, Spain., Berenguer-Diez MA; Servicio de Urgencias, Hospital General Universitario Doctor Peset, Valencia, Spain., Guiu S; Servicio de Urgencias, Hospital Universitario Son Espases, Illes Balears, Spain., López-Laguna N; Servicio de Urgencias, Clinica Universitaria Navarra, Madrid, Spain., Delgado-Sardina V; Servicio de Urgencias, Hospital Alvaro Cunqueiro, Pontevedra, Spain., Diego-Robledo FJ; Servicio de Urgencias, Hospital Universitario de Salamanca, Salamanca, Spain., Ezponda P; Servicio de Urgencias, Hospital de Zumarraga, Gipuzkoa, Spain., Martínez-Lorenzo A; Servicio de Urgencias, Hospital Virxe da Xunqueira, A Coruna, Spain., Ortega-Liarte JV; Servicio de Urgencias, Hospital Universitario Los Arcos del Mar Menor, San Javier, Murcia, Spain., García-Rupérez I; Servicio de Urgencias, Hospital Universitario Río Ortega, Valladolid, Spain., Borne-Jerez S; Servicio de Urgencias, Hospital Juan Ramón Jiménez, Huelva, Spain., Gil-Rodrigo A; Servicio de Urgencias, Unidad de Estancia Corta y Hospitalización a Domicilio, Hospital General Doctor Balmis, Instituto de Investigación Sanitaria y Biómedica de Alicante (ISABIAL), Universidad Miguel Hernández, Alicante, Spain., Llorens P; Servicio de Urgencias, Unidad de Estancia Corta y Hospitalización a Domicilio, Hospital General Doctor Balmis, Instituto de Investigación Sanitaria y Biómedica de Alicante (ISABIAL), Universidad Miguel Hernández, Alicante, Spain., Miró Ò; Área de Urgencias, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain.
Jazyk: angličtina
Zdroj: Internal and emergency medicine [Intern Emerg Med] 2024 Jun 19. Date of Electronic Publication: 2024 Jun 19.
DOI: 10.1007/s11739-024-03638-z
Abstrakt: The elderly population frequently consults the emergency department (ED). This population could have greater use of EDs and hospital health resources. The EDEN cohort of patients aged 65 years or older visiting the ED allowed this association to be investigated. To analyse the association between healthcare resource use and the characteristics of patients over 65 years of age who consult hospital EDs. We performed an analysis of the EDEN cohort, a retrospective, analytical, and multipurpose registry that includes patients over 65 years of age who consulted in 52 Spanish EDs. The impact of age, sex, and characteristics of ageing on the following outcomes was studied: need for hospital admission (primary outcome) and need for observation, stay in the ED > 12 h, prolonged hospital stay > 7 days, need for intensive care unit (ICU) and return to the ED at 30 days related to the index visit (secondary outcomes). The association was analysed by calculating the adjusted odds ratios (aOR) and their 95% confidence intervals (CI), using a logistic regression model. A total of 25,557 patients with a mean age of 78.3 years were analysed, 45% were males. Of note was the presence of comorbidity, a Charlson index ≥ 3 (33%), and polypharmacy (66%). Observation in the ED was required by 26%, 25.4% were admitted to the hospital, and 0.9% were admitted to the ICU. The ED stay was > 12 h in 12.5% and hospital stay > 7 days in 13.5% of cases. There was a progressive increase in healthcare resource use based on age, with an aOR for the need for observation of 2.189 (95% CI 2.038-2.352), ED stay > 12 h 2.136 (95% CI 1.942-2.349) and hospital admission 2.579 (95% CI 2.399-2.772) in the group ≥ 85 years old. Most of the characteristics inherent to ageing (cognitive impairment, falls in the previous 6 months, polypharmacy, functional dependence, and comorbidity) were associated with significant increases in the use of healthcare resources, except for ICU admission, which was less in all the variables studied. Age and the characteristics inherent to ageing are associated with greater use of structural healthcare resources.
(© 2024. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI).)
Databáze: MEDLINE
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