Disability and morbidity among older patients in the emergency department: a Danish population-based cohort study

Autor: Annmarie Touborg Lassen, Anette Tanderup, Jesper Ryg, Jens-Ulrik Rosholm
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Denmark
Geriatric Medicine
geriatric emergency medicine
Cohort Studies
Hospitals
University
Disability Evaluation
0302 clinical medicine
Patient Admission
Health care
030212 general & internal medicine
Hospital Mortality
Prospective Studies
Prospective cohort study
Aged
80 and over
education.field_of_study
Attendance
geriatric patients
General Medicine
older patients
Patient Discharge
Population Surveillance
Emergency Service
Hospital
Cohort study
medicine.medical_specialty
emergency department
Geriatric patients
Population
Geriatric emergency medicine
Patient Readmission
Risk Assessment
Sensitivity and Specificity
03 medical and health sciences
medicine
Older patients
Humans
Mortality
education
Geriatric Assessment
Aged
Polypharmacy
business.industry
Emergency department
Research
030208 emergency & critical care medicine
Length of Stay
medicine.disease
Comorbidity
mortality
Logistic Models
Emergency medicine
Morbidity
business
Zdroj: BMJ Open
Tanderup, A, Lassen, A T, Rosholm, J-U & Ryg, J 2018, ' Disability and morbidity among older patients in the emergency department : a Danish population-based cohort study ', BMJ Open, vol. 8, no. 12, e023803 . https://doi.org/10.1136/bmjopen-2018-023803
ISSN: 2044-6055
DOI: 10.1136/bmjopen-2018-023803
Popis: ObjectivesThe objective was to describe the prevalence of geriatric conditions among older medical patients in the emergency department (ED) and the association with admission, mortality, reattendance and loss of independency.DesignPopulation-based prospective cohort study.SettingED of a large university hospital.ParticipantsAll medical patients ≥65 years of age from a single municipality with a first attendance to the ED during a 1-year period (November 2013 to November 2014).Primary and secondary outcome measuresBased on information from healthcare registers, we defined geriatric conditions as disability, recently increased disability, polypharmacy and comorbidity. Outcomes were admission, length of admission, 30 days postdischarge mortality, 30 days hospital reattendance and home care dependency 0–360 days following ED contact.ResultsTotally, 3775 patients (55% women) were included, age 78 (71–85) years (median (IQR)). No patients were lost to follow-up. The prevalence of 0–4 geriatric conditions was 14.9%, 27.3%, 25.2%, 22.3% and 10.3%, respectively. The number of conditions was significantly associated with hospital admission, length of admission, 30 days postdischarge mortality and 30 days hospital reattendance. Among patients with no geriatric conditions, 70% lived independent all 360 days after discharge, whereas all patients with ≥3 conditions had some dependency or were dead within 360 days following discharge.ConclusionAmong older medical patients in the ED, 50% had two or more geriatric conditions which were associated with poor health outcomes. This highlights the need for studies of the effect of geriatric awareness and competences in the ED.
Databáze: OpenAIRE
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