Premium
Emergency department use by nonagenarian patients
Author(s) -
Iwata Mitsunaga,
Kuzuya Masafumi,
Kitagawa Yoshimi,
Iguchi Akihisa
Publication year - 2006
Publication title -
geriatrics and gerontology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 57
eISSN - 1447-0594
pISSN - 1444-1586
DOI - 10.1111/j.1447-0594.2006.00310.x
Subject(s) - medicine , emergency department , polypharmacy , comorbidity , pneumonia , emergency medicine , population , depression (economics) , stroke (engine) , pediatrics , psychiatry , mechanical engineering , environmental health , engineering , economics , macroeconomics
Background: In accord with the rapid growth of the nonagenarian population, their emergency departments (ED) visits are increasing. The aim of our study was to examine ED use by nonagenarian patients and their dispositions. Method: We analyzed 275 consecutive ED visits of nonagenarian patients in Japan during 1 year. Demographic data, chief complaint, diagnosis, categories of urgency, and disposition following the ED visit were recorded. A 1‐year follow up was conducted on all discharged nonagenarian patients. Results: A total of 199 patients made 275 visits. Of these patients, 56.4% were transferred by ambulance, 15.6% were classified as emergency, and 65.1% led to hospitalization. Fever, fall, altered mental status, anorexia, focal neurological deficits and general fatigue accounted for 72% of the reasons for ED visits, and 43% of their ED visits resulted in a diagnosis of pneumonia, stroke, head trauma or hip fracture. In hospitalized patients, the mean length of stay was 23.4 days. Most of the patients had geriatric problems such as disability (78%), comorbidity (86%) and polypharmacy (82%). The in‐hospital mortality of the 179 hospitalized patients was 19.6% (35/179). Eighty‐six percent of alive patients were discharged to long‐term care facilities (124/144). The total 1‐year mortality of the 199 patients who visited the ED accounted for 49.2% (98/199). Conclusion: Nonagenarians’ ED visits were associated with prolonged admissions, postdischarge institutionalizations, and high risk of in‐hospital and postdischarge death. Their ED visits seemed to be a major transition in their own life.