Research Article
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Year 2019, , 413 - 422, 30.06.2019

Yusuf Kenan Tekin , Erdal Demirtaş , Naim Nur , İlhan Korkmaz

https://doi.org/10.7197/223.vi.571281

Abstract

References

  • 1. Demographic change in the Euro Area. Projections and consequences. In: Bulletin Monthly (ed) European Central Bank (ECB). European Central Bank, Frankfurt am Main, pp. 49-64. 2006.
  • 2. Turkish Statistical Institute, Demographic projections: 2008‐2050, unpublished data (İn Turkish), 2009.
  • 3. Goldstein JR. How population age. In Uhlenberg, P. (ed). International. Handbook of Population Aging. Springer: New York: pp. 7-18. 2009.
  • 4. Turkish Statistical Institute, Elderly statistics, 2014. Available from: http://www.turkstat.gov.tr/PreHaberBultenleri.do?id=16057. Accessed on Jenuary 10, 2017.
  • 5. Platts-Mills TF, Leacock B, Cabanas JG, Shofer FS, McLean SA. Emergency medical services use by the elderly: analysis of a statewide database. Prehosp Emerg Med 2010;14:329-33.
  • 6. Braes T, Moons P, Lipkens P, Sterckx W, Sabbe M, Flamaing J, et al. Screening for risk of unplanned readmission in older patients admitted to hospital: predictive accuracy of three instruments. Aging Clin Exp Res 2010;22(4):345-51.
  • 7. Yenal S, Keser G, Mandıracıoğlu A, Yalçın MA, Bayram B, Akçiçek F, The determination of the status of emergency department use by elderly patients and of the indicators for ambulance use. Turkish Journal of Geriatrics 2018;21(2):109-17.
  • 8. Keskinoğlu P, Inan F. Analysis of emergency department visits by elderly patients in an urban public hospital in Turkey. J Clin Gerontol Geriatr 2014;5:127-31. 9. Vilpert S, Jaccard-Ruedin H, Trueb L, Monod-Zorzi S, Yersin B, Büla C . Emergency department use by oldest-old patients from 2005 to 2010 in a Swiss University hospital. BMC Health Serv Res 2013;13:344.
  • 10. Aminzadeh F, Dalziel WB. Older adults in the emergency department: a systematic review of patterns of use, adverse outcomes, and effectiveness of interventions. Ann Emerg Med 2002;39:238-47.
  • 11. Samaras N, Chevalley T, Samaras D, Gold G. Older patients in the emergency department: a review. Ann Emerg Med 2010;56:261-9.
  • 12. McCusker J, Verdon J. Do geriatric interventions reduce emergency department visits? A systematic review. J Gerontol A Biol Sci Med Sci 2006;61:53-62. 13. McCusker J, Dendukuri N, Tousignant P, Verdon J, Poulin de Courval L, Belzile E. Rapid two-stage emergency department intervention for seniors: impact on continuity of care. Acad Emerg Med 2003; 10(3): 233-43.
  • 14. Latham LP, Ackroyd-Stolarz S. Emergency department utilization by older adults: a descriptive study. Can Geriatr J 2014;17(4):118-25. Doi: 10.5770/cgj.17.108.
  • 15. Gulacti U, Lok U, Celik M , Aktas N, Polat H. The ED use and non-urgent visits of elderly patients. Turk J Emerg Med 2016;16(4):141-5.
  • 16. Wilber ST, Gerson LW. Emergency department care. In: Halter JB, Ouslander JG, Tinetti ME, et al., editors. Hazzard’s geriatric medicine and gerontology, 6th edition. New York: McGraw-Hill; 2009.
  • 17. Gruneir A, Silver MJ, Rochon PA. Emergency department use by older adults: a literature review on trends, appropriateness, and consequences of unmet health care needs. Med Care Res Rev 2011;68(2):131-55.
  • 18.  Trzeciak S, Rivers EP. Emergency department overcrowding in the United States: an emerging threat to patient safety and public health. Emerg Med J 2003;20(5):402-5.
  • 19.  Meurer WJ, Potti TA, Kerber KA, Sasson C, Macy ML, West BT, et al. Potentially inappropriate medication utilization in the emergency department visits by older adults: analysis from a nationally representative sample. Acad Emerg Med 2010;17(3):231-7.
  • 20. Pines JM, Mullins PM, Cooper JK, Feng LB, Roth KE. National trends in emergency department use, care patterns, and quality of care of older adults in the United States. J Am Geriatr Soc 2013;61(1):12-7.
  • 21. Downing A, Wilson R. Older people’s use of accident and emergency services. Age Ageing 2005;34(1):24-30.
  • 22. Carron PN, Mabire C, Yersin B, Büla C. Nursing home residents at the emergency department: a 6-year retrospective analysis in a Swiss academic hospital. Int Emerg Med 2017;12(2):229-37.
  • 23. Li G, Lau JT, McCarthy ML, Schull MJ, Vermeulen M, Kelen GD. Emergency department utilization in the United States and Ontario, Canada. Acad Emerg Med 2007;14(6):582-4.
  • 24. Pitts SR, Niska RW, Xu J, Burt CW. National hospital ambulatory medical care Survey: 2006 emergency department summary. Natl Health Stat Rep 2008;7:1-38.
  • 25.  Çiğşar G, Akkuş Y, Elnare, G Esma, Erdemir Öztürk E, Palas MB. Aetiology of emergency department admission of the elderly: a retrospective study in Kars. Turk J Geriatr 2016;19(1):19-26.
  • 26. Fayyaz J, Khursheed M, Mir MU, Khan U. Pattern of emergency department visits by elderly patients: study from a tertiary care hospital, Karachi. BMC Geriatr 2013;13:83.
  • 27. Shaha M, Gmuer S, Schoenenberger AW, Gerber FS, Exadaktylos AK. Trends and characteristics of attendance at the emergency department of a Swiss university hospital: 2002-2012. Swiss Med Wkly 2015;145:w14141.
  • 28. Bissett M, Cusick A, Lannin NA. Functional assessments utilised in emergency departments: a systematic review. Age Ageing 2013;42(2):163-72.
  • 29. Sinha SK, Bessman ES, Flomenbaum N, Left B. A systematic review and qualitative analysis to inform the development of a new emergency department-based geriatric case management model. Ann Emerg Med 2011;57(6):672-82.
  • 30.  McCusker J, Verdon J, Vadeboncoeur A, Lévesque JF, Sinha SK, Kim KY, et al. The elder-friendly emergency department assessment tool: development of a quality assessment tool for emergency department-based geriatric care. J Am Geriatr Soc 2012;60(8):1534-39.
  • 31.  Conroy SP, Ansari K, Williams M Laithwaite E, Teasdale B, Dawson J, et al. A controlled evaluation of comprehensive geriatric assessment in the emergency department: The ‘Emergency Frailty Unit’. Age Ageing 2014;43(1):109-14. 32. Beauchet O, Launay CP, Fantino B, Lerolle N, Maunoury F, Annweiler C. Screening for elderly patients admitted to the emergency department requiring specialized geriatric care. J Emerg Med. 2013;45(5):739-45.
  • 33. McCusker J, Ionescu-Ittu R, Ciampi A, Vadeboncoeur A, Roberge D, Larouche D, et al. Hospital characteristics and emergency department care of older patients are associated with return visits. Acad Emerg Med 2007;14(5):426-33.
  • 34. Gray LC, Peel NM, Costa AP Burkett E, Dey AB, Jonsson PV, et al. Profiles of older patients in the emergency department: findings from the interRAI Multinational Emergency Department Study. Ann Emerg Med. 2013;62(5):467-74.
  • 35. Grief CL. Patterns of ED use and perceptions of the elderly regarding their emergency care: A synthesis of recent research. J Emerg Nurs. 2003;29(2):122-26.

Characteristics and outcomes of older patients attending the emergency department at an academic university hospital

Year 2019, , 413 - 422, 30.06.2019

Yusuf Kenan Tekin , Erdal Demirtaş , Naim Nur , İlhan Korkmaz

https://doi.org/10.7197/223.vi.571281

Abstract

Objective: Because older populations have been increased
significantly over the last decades globally, emergency departments (ED) have
become a vital place in the care of older patients. Characterizing the usage of
the ED by older patients will facilitate the qualifying planning activities in
emergency care delivery.

Method: The retrospective data were extracted from a database
and included all patients, aged 65 years or over, admitted to the ED between 1
January 2017- 31 December 2017.

Results: The rate of ED visits
accounted for 16.1%. A large majority of the ED visits were during the day
shift (49.6 %), and in summer months (June-August 28.7 %). The most common
diagnoses (18.4%) were cardiovascular conditions. A large majority (67.8%) of
ED visits involved diagnostic imaging and nearly half (46.7%) of them received
consultation services. Nearly one-third (31.3%) of older patients were admitted
to hospital following their ED visit. Hospital admission, length of stay in ED,
having consulting service, involving some kind of diagnostic imaging and being
triaged as urgent/emergent are more likely to be increased with age group.







Conclusions:
ED visits increase with age and also
the resource use intensity of the ED, including the length of stay, diagnostic
imaging, consultation and admission to the hospital after an ED visit appears
to increase with ageing. Patterns of the ED usage were described in this study
may be helpful in resource planning, or may provide an approach for the future
the investigation involving improved or alternative care options for the older
patient.

Keywords

Emergency service geriatric patients

References

  • 1. Demographic change in the Euro Area. Projections and consequences. In: Bulletin Monthly (ed) European Central Bank (ECB). European Central Bank, Frankfurt am Main, pp. 49-64. 2006.
  • 2. Turkish Statistical Institute, Demographic projections: 2008‐2050, unpublished data (İn Turkish), 2009.
  • 3. Goldstein JR. How population age. In Uhlenberg, P. (ed). International. Handbook of Population Aging. Springer: New York: pp. 7-18. 2009.
  • 4. Turkish Statistical Institute, Elderly statistics, 2014. Available from: http://www.turkstat.gov.tr/PreHaberBultenleri.do?id=16057. Accessed on Jenuary 10, 2017.
  • 5. Platts-Mills TF, Leacock B, Cabanas JG, Shofer FS, McLean SA. Emergency medical services use by the elderly: analysis of a statewide database. Prehosp Emerg Med 2010;14:329-33.
  • 6. Braes T, Moons P, Lipkens P, Sterckx W, Sabbe M, Flamaing J, et al. Screening for risk of unplanned readmission in older patients admitted to hospital: predictive accuracy of three instruments. Aging Clin Exp Res 2010;22(4):345-51.
  • 7. Yenal S, Keser G, Mandıracıoğlu A, Yalçın MA, Bayram B, Akçiçek F, The determination of the status of emergency department use by elderly patients and of the indicators for ambulance use. Turkish Journal of Geriatrics 2018;21(2):109-17.
  • 8. Keskinoğlu P, Inan F. Analysis of emergency department visits by elderly patients in an urban public hospital in Turkey. J Clin Gerontol Geriatr 2014;5:127-31. 9. Vilpert S, Jaccard-Ruedin H, Trueb L, Monod-Zorzi S, Yersin B, Büla C . Emergency department use by oldest-old patients from 2005 to 2010 in a Swiss University hospital. BMC Health Serv Res 2013;13:344.
  • 10. Aminzadeh F, Dalziel WB. Older adults in the emergency department: a systematic review of patterns of use, adverse outcomes, and effectiveness of interventions. Ann Emerg Med 2002;39:238-47.
  • 11. Samaras N, Chevalley T, Samaras D, Gold G. Older patients in the emergency department: a review. Ann Emerg Med 2010;56:261-9.
  • 12. McCusker J, Verdon J. Do geriatric interventions reduce emergency department visits? A systematic review. J Gerontol A Biol Sci Med Sci 2006;61:53-62. 13. McCusker J, Dendukuri N, Tousignant P, Verdon J, Poulin de Courval L, Belzile E. Rapid two-stage emergency department intervention for seniors: impact on continuity of care. Acad Emerg Med 2003; 10(3): 233-43.
  • 14. Latham LP, Ackroyd-Stolarz S. Emergency department utilization by older adults: a descriptive study. Can Geriatr J 2014;17(4):118-25. Doi: 10.5770/cgj.17.108.
  • 15. Gulacti U, Lok U, Celik M , Aktas N, Polat H. The ED use and non-urgent visits of elderly patients. Turk J Emerg Med 2016;16(4):141-5.
  • 16. Wilber ST, Gerson LW. Emergency department care. In: Halter JB, Ouslander JG, Tinetti ME, et al., editors. Hazzard’s geriatric medicine and gerontology, 6th edition. New York: McGraw-Hill; 2009.
  • 17. Gruneir A, Silver MJ, Rochon PA. Emergency department use by older adults: a literature review on trends, appropriateness, and consequences of unmet health care needs. Med Care Res Rev 2011;68(2):131-55.
  • 18.  Trzeciak S, Rivers EP. Emergency department overcrowding in the United States: an emerging threat to patient safety and public health. Emerg Med J 2003;20(5):402-5.
  • 19.  Meurer WJ, Potti TA, Kerber KA, Sasson C, Macy ML, West BT, et al. Potentially inappropriate medication utilization in the emergency department visits by older adults: analysis from a nationally representative sample. Acad Emerg Med 2010;17(3):231-7.
  • 20. Pines JM, Mullins PM, Cooper JK, Feng LB, Roth KE. National trends in emergency department use, care patterns, and quality of care of older adults in the United States. J Am Geriatr Soc 2013;61(1):12-7.
  • 21. Downing A, Wilson R. Older people’s use of accident and emergency services. Age Ageing 2005;34(1):24-30.
  • 22. Carron PN, Mabire C, Yersin B, Büla C. Nursing home residents at the emergency department: a 6-year retrospective analysis in a Swiss academic hospital. Int Emerg Med 2017;12(2):229-37.
  • 23. Li G, Lau JT, McCarthy ML, Schull MJ, Vermeulen M, Kelen GD. Emergency department utilization in the United States and Ontario, Canada. Acad Emerg Med 2007;14(6):582-4.
  • 24. Pitts SR, Niska RW, Xu J, Burt CW. National hospital ambulatory medical care Survey: 2006 emergency department summary. Natl Health Stat Rep 2008;7:1-38.
  • 25.  Çiğşar G, Akkuş Y, Elnare, G Esma, Erdemir Öztürk E, Palas MB. Aetiology of emergency department admission of the elderly: a retrospective study in Kars. Turk J Geriatr 2016;19(1):19-26.
  • 26. Fayyaz J, Khursheed M, Mir MU, Khan U. Pattern of emergency department visits by elderly patients: study from a tertiary care hospital, Karachi. BMC Geriatr 2013;13:83.
  • 27. Shaha M, Gmuer S, Schoenenberger AW, Gerber FS, Exadaktylos AK. Trends and characteristics of attendance at the emergency department of a Swiss university hospital: 2002-2012. Swiss Med Wkly 2015;145:w14141.
  • 28. Bissett M, Cusick A, Lannin NA. Functional assessments utilised in emergency departments: a systematic review. Age Ageing 2013;42(2):163-72.
  • 29. Sinha SK, Bessman ES, Flomenbaum N, Left B. A systematic review and qualitative analysis to inform the development of a new emergency department-based geriatric case management model. Ann Emerg Med 2011;57(6):672-82.
  • 30.  McCusker J, Verdon J, Vadeboncoeur A, Lévesque JF, Sinha SK, Kim KY, et al. The elder-friendly emergency department assessment tool: development of a quality assessment tool for emergency department-based geriatric care. J Am Geriatr Soc 2012;60(8):1534-39.
  • 31.  Conroy SP, Ansari K, Williams M Laithwaite E, Teasdale B, Dawson J, et al. A controlled evaluation of comprehensive geriatric assessment in the emergency department: The ‘Emergency Frailty Unit’. Age Ageing 2014;43(1):109-14. 32. Beauchet O, Launay CP, Fantino B, Lerolle N, Maunoury F, Annweiler C. Screening for elderly patients admitted to the emergency department requiring specialized geriatric care. J Emerg Med. 2013;45(5):739-45.
  • 33. McCusker J, Ionescu-Ittu R, Ciampi A, Vadeboncoeur A, Roberge D, Larouche D, et al. Hospital characteristics and emergency department care of older patients are associated with return visits. Acad Emerg Med 2007;14(5):426-33.
  • 34. Gray LC, Peel NM, Costa AP Burkett E, Dey AB, Jonsson PV, et al. Profiles of older patients in the emergency department: findings from the interRAI Multinational Emergency Department Study. Ann Emerg Med. 2013;62(5):467-74.
  • 35. Grief CL. Patterns of ED use and perceptions of the elderly regarding their emergency care: A synthesis of recent research. J Emerg Nurs. 2003;29(2):122-26.
There are 32 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Surgical Science Research Articles
Authors

Yusuf Kenan Tekin 0000-0001-8047-4836

Erdal Demirtaş 0000-0003-0853-0623

Naim Nur 0000-0002-7675-9342

İlhan Korkmaz 0000-0001-5182-3136

Publication Date June 30, 2019
Acceptance Date June 26, 2019
Published in Issue Year 2019

Cite

AMA Tekin YK, Demirtaş E, Nur N, Korkmaz İ. Characteristics and outcomes of older patients attending the emergency department at an academic university hospital. CMJ. June 2019;41(2):413-422. doi:10.7197/223.vi.571281