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The number of emergency admissions to hospital has increased in recent years. Greater expectations from patients, the increased use of 'on-call' GP services and increased pressure from the emergency department due to the four-hour wait target are among the causal factors suggested to lower the threshold for admission and increase inappropriate admissions. Increasing age is also associated with increased admission rates and the elderly are the most rapidly increasing group among emergency surgical admissions. Emergency surgery has more risks in the elderly due to reduced cardio-respiratory reserves and greater co-morbidities. In addition, the elderly often have greater social needs, requiring social service input prior to discharge. With the current reduction in community and convalescent beds the length of acute hospital admissions in the elderly is predicted to rise.

Non-Elective Admission of Patients Aged 75 Years and Over to the Surgical Assessment Unit of an Acute Hospital