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논문 기본 정보

자료유형
학술저널
저자정보
Nere Larrea Aguirre (Research Unit, Galdakao-Usansolo University Hospital, Vizcaya, Spain. Kronikgune Institute for Health Services Research, Barakaldo, Spain) Susana García Gutiérrez (Research Unit, Galdakao-Usansolo University Hospital, Vizcaya, Spain. Kronikgune Institute for Health Services Research, Barakaldo, Spain) Oscar Miro (Emergency Department, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain) Sira Aguiló (Emergency Department, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain) Javier Jacob (Emergency Department, Hospital de la Santa Creu I Sant Pau, Barcelona, Catalonia, Spain) Aitor Alquézar-Arbé (Emergency Department, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Catalonia, Spain) Guillermo Burillo (Emergency Department, Hospital Universitario de Canarias, University of La Laguna, Tenerife, Spain) Cesáreo Fernandez (Emergency Department, Hospital Clínico San Carlos, IdISSC, Madrid, Spain) Pere Llorens (Emergency Department, Hospital General Universitario Dr. Balmis de Alicante, Alicante, Spain) Cesar Roza Alonso (Emergency Department, Hospital del Nalón, Langreo, Asturias, Spain) Ivana Tavasci Lopez (Emergency Department, Hospital Virgen de Altagracia, Ciudad Real, Spain) Mónica Cañete (Emergency Department, Hospital Nuestra Señora del Prado de Talavera de la Reina, Toledo, Spain) Pedro Ruiz Asensio (Emergency Department, Hospital Universitario Vinalopó, Alicante, Spain) Beatriz Paderne Díaz (Emergency Department, Hospital Universitario de Móstoles, Madrid, Spain) Teresa Pablos Pizarro (Emergency Department, Hospital Virgen del Rocio, Sevilla, Spain) Rigoberto Jesús del Rio Navarro (Emergency Department, Hospital General Universitario Dr. Peset, Valencia, Spain) Núria Perelló Viola (Emergency Department, Hospital Universitario Son Espases, Mallorca, Spain) Lourdes Hernández-Castells (Emergency Department, Clinica Universitaria Navarra, Madrid, Spain) Alejandro Cortés Soler (Emergency Department, Clinico Universitario de Valencia, Valencia, Spain) Elena Sánchez Fernández-Linares (Emergency Department, Hospital Alvaro Cunqueiro, Pontevedra, Spain) Jesús Ángel Sánchez Serrano (Emergency Department, Hospital Universitario de Salamanca, Salamanca, Spain) Patxi Ezponda (Emergency Department, Hospital De Zumarraga, Guipuzcoa, Spain) Andrea Martínez Lorenzo (Emergency Department, Hospital Virxe Da Xunqueira, A Coruña, Spain) Juan Vicente Ortega Liarte (Emergency Department, Hospital Universitario Los Arcos del Mar Menor, San Javier, Murcia, Spain) Susana Sánchez Ramón (Emergency Department, Hospital Universitario Río Ortega, Valladolid, Spain) Asumpta Ruiz Aranda (Emergency Department, Hospital Juan Ramón Jiménez, Huelva, Spain) Francisco Javier Martín-Sánchez (Emergency Department, Hospital Clínico San Carlos, IdISSC, Madrid, Spain) Juan González del Castillo (Emergency Department, Hospital Clínico San Carlos, IdISSC, Madrid, Spain) on behalf of the members of the SIESTA Network (on behalf of the members of the SIESTA Network)
저널정보
대한노인병학회 Annals of geriatric medicine and research Annals of geriatric medicine and research Vol.28 No.1
발행연도
2024.3
수록면
9 - 19 (11page)
DOI
10.4235/agmr.23.0121

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Background: While multidimensional and interdisciplinary assessment of older adult patients improves their short-term outcomes after evaluation in the emergency department (ED), this assessment is time-consuming and ill-suited for the busy environment. Thus, identifying patients who will benefit from this strategy is challenging. Therefore, this study aimed to identify older adult patients suitable for a different ED approach as well as independent variables associated with poor short-term clinical outcomes. Methods: We included all patients ≥65 years attending 52 EDs in Spain over 7 days. Sociodemographic, comorbidity, and baseline functional status data were collected. The outcomes were 30-day mortality, re-presentation, hospital readmission, and the composite of all outcomes. Results: During the study among 96,014 patients evaluated in the ED, we included 23,338 patients ≥65 years—mean age, 78.4±8.1 years; 12,626 (54.1%) women. During follow-up, 5,776 patients (24.75%) had poor outcomes after evaluation in the ED: 1,140 (4.88%) died, 4,640 (20.51) returned to the ED, and 1,739 (7.69%) were readmitted 30 days after discharge following the index visit. A model including male sex, age ≥75 years, arrival by ambulance, Charlson Comorbidity Index ≥3, and functional impairment had a C-index of 0.81 (95% confidence interval, 0.80–0.82) for 30-day mortality. Conclusion: Male sex, age ≥75 years, arrival by ambulance, functional impairment, or severe comorbidity are features of patients who could benefit from approaches in the ED different from the common triage to improve the poor short-term outcomes of this population.
#Emergencies #Geriatrics #Frail elderly #Triage

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