Characteristics and outcomes of older persons attending the emergency department: a retrospective cohort study

Hdl Handle:
http://hdl.handle.net/10147/322910
Title:
Characteristics and outcomes of older persons attending the emergency department: a retrospective cohort study
Authors:
Kennelly, S. P.; Drumm, B.; Coughlan, T.; Collins, R.; O'Neill, D.; Romero-Ortuno, R.
Citation:
Kennelly SP et al. Characteristics and outcomes of older persons attending the emergency department: a retrospective cohort study 2014 QJM Jun 16 [epub ahead of print]
Publisher:
QJM: An International Journal of Medicine
Journal:
QJM
Issue Date:
Jun-2014
URI:
http://hdl.handle.net/10147/322910
DOI:
10.1093/qjmed/hcu111
Additional Links:
http://www.qjmed.oxfordjournals.org/cgi/doi/10.1093/qjmed/hcu111
Abstract:
Background: The analysis of routinely collected hospital data informs the design of specialist services for at-risk older people. Aim: Describe the outcomes of a cohort of older emergency department (ED) attendees and identify predictors of these outcomes. Design: retrospective cohort study. Methods: All patients aged 65 years or older attending an urban university hospital ED in January 2012 were included (N = 550). Outcomes were retrospectively followed for 12 months. Statistical analyses were based on multivariate binary logistic regression models and classification trees. Results: Of N = 550, 40.5% spent ≤6 h in the ED, but the proportion was 22.4% among those older than 81 years and not presenting with musculoskeletal problems/fractures. N = 349 (63.5%) were admitted from the ED. A significant multivariate predictor of in-hospital mortality was Charlson comorbidity index [CCI; odds ratio = 1.19, 95% confidence interval: 1.07, 1.34, P = 0.002]. Among patients who were discharged from ED without admission or after their first in-patient admission (N = 499), 232 (46.5%) re-attended ED within 1 year, with CCI being the best predictor of re-attendance (CCI ≤ 4: 25.8%, CCI > 5: 60.4%). Among N = 499, 34 (6.8%) had died after 1 year of initial ED presentation. The subgroup (N = 114) with the highest mortality (17.5%) was composed by those aged >77 years and brought in by ambulance on initial presentation.
Item Type:
Article
Language:
en
Keywords:
EMERGENCY MEDICAL CARE; OLDER PEOPLE
ISSN:
1460-2725; 1460-2393

Full metadata record

DC FieldValue Language
dc.contributor.authorKennelly, S. P.en_GB
dc.contributor.authorDrumm, B.en_GB
dc.contributor.authorCoughlan, T.en_GB
dc.contributor.authorCollins, R.en_GB
dc.contributor.authorO'Neill, D.en_GB
dc.contributor.authorRomero-Ortuno, R.en_GB
dc.date.accessioned2014-07-15T11:05:30Z-
dc.date.available2014-07-15T11:05:30Z-
dc.date.issued2014-06-
dc.identifier.citationKennelly SP et al. Characteristics and outcomes of older persons attending the emergency department: a retrospective cohort study 2014 QJM Jun 16 [epub ahead of print]en_GB
dc.identifier.issn1460-2725-
dc.identifier.issn1460-2393-
dc.identifier.doi10.1093/qjmed/hcu111-
dc.identifier.urihttp://hdl.handle.net/10147/322910-
dc.description.abstractBackground: The analysis of routinely collected hospital data informs the design of specialist services for at-risk older people. Aim: Describe the outcomes of a cohort of older emergency department (ED) attendees and identify predictors of these outcomes. Design: retrospective cohort study. Methods: All patients aged 65 years or older attending an urban university hospital ED in January 2012 were included (N = 550). Outcomes were retrospectively followed for 12 months. Statistical analyses were based on multivariate binary logistic regression models and classification trees. Results: Of N = 550, 40.5% spent ≤6 h in the ED, but the proportion was 22.4% among those older than 81 years and not presenting with musculoskeletal problems/fractures. N = 349 (63.5%) were admitted from the ED. A significant multivariate predictor of in-hospital mortality was Charlson comorbidity index [CCI; odds ratio = 1.19, 95% confidence interval: 1.07, 1.34, P = 0.002]. Among patients who were discharged from ED without admission or after their first in-patient admission (N = 499), 232 (46.5%) re-attended ED within 1 year, with CCI being the best predictor of re-attendance (CCI ≤ 4: 25.8%, CCI > 5: 60.4%). Among N = 499, 34 (6.8%) had died after 1 year of initial ED presentation. The subgroup (N = 114) with the highest mortality (17.5%) was composed by those aged >77 years and brought in by ambulance on initial presentation.en_GB
dc.language.isoenen
dc.publisherQJM: An International Journal of Medicineen_GB
dc.relation.urlhttp://www.qjmed.oxfordjournals.org/cgi/doi/10.1093/qjmed/hcu111en_GB
dc.rightsArchived with thanks to QJMen_GB
dc.subjectEMERGENCY MEDICAL CAREen_GB
dc.subjectOLDER PEOPLEen_GB
dc.titleCharacteristics and outcomes of older persons attending the emergency department: a retrospective cohort studyen_GB
dc.typeArticleen
dc.identifier.journalQJMen_GB
dc.description.fundingNo fundingen
dc.description.provinceLeinsteren
dc.description.peer-reviewpeer-reviewen
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