How different are older people discharged from emergency departments compared with those admitted to hospital?

TY - JOUR

T1 - How different are older people discharged from emergency departments compared with those admitted to hospital?

AU - Naughton, Corina

AU - Drennan, Jonathan

AU - Treacy, Pearl

AU - Fealy, Gerard

AU - Kilkenny, Margaret

AU - Johnson, Felicity

AU - Butler, Michelle

PY - 2010/4/28

Y1 - 2010/4/28

N2 - OBJECTIVE: To compare the characteristics of older people presenting to the emergency department (ED) and admitted to hospital with those discharged directly from the ED and identify factors independently associated with hospital admission. DESIGN: This is a cross-sectional survey of 306 community dwelling people aged 65 years or older presenting to two hospital EDs. A structured questionnaire and ED records were used to collect patient demographics, socioeconomic, physical, cognitive and social network information. STATISTICS: The profile of admitted and discharged patients was compared using the chi statistic. Logistic regression was used to identify factors independently associated with hospital admission. Odds ratios (OR) and 95% confidence intervals (CI) are presented. RESULTS: The analysis involved 306 patients, 158 admitted and 148 discharged home. There was no significant difference in demographic, socioeconomic, cognitive and social networks between the groups. Factors independently associated with hospital admission in the multivariate model were as follows: prior hospital admission OR 6.16 (95% CI 2.61, 14.50), Manchester Triage category 1-2 OR 5.01 (95% CI 1.19, 21.10), low-energy levels OR 3.97 (95% CI 1.32, 11.9) and presenting with cardiac OR 3.59 (95% CI 1.05, 12.3), neurological OR 4.47 (95% CI 1.21, 16.5) or respiratory-related conditions OR 11.2 (95% CI 2.41, 51.9). Among the cohort of discharged patients, 20-30% shared similar physical and mental health characteristics to admitted patients. CONCLUSION: In this elderly population, health-related variables were the only independent factors associated with hospital admission. Approximately 30% of patients discharged home from ED had similar risk profiles to admitted patients.

AB - OBJECTIVE: To compare the characteristics of older people presenting to the emergency department (ED) and admitted to hospital with those discharged directly from the ED and identify factors independently associated with hospital admission. DESIGN: This is a cross-sectional survey of 306 community dwelling people aged 65 years or older presenting to two hospital EDs. A structured questionnaire and ED records were used to collect patient demographics, socioeconomic, physical, cognitive and social network information. STATISTICS: The profile of admitted and discharged patients was compared using the chi statistic. Logistic regression was used to identify factors independently associated with hospital admission. Odds ratios (OR) and 95% confidence intervals (CI) are presented. RESULTS: The analysis involved 306 patients, 158 admitted and 148 discharged home. There was no significant difference in demographic, socioeconomic, cognitive and social networks between the groups. Factors independently associated with hospital admission in the multivariate model were as follows: prior hospital admission OR 6.16 (95% CI 2.61, 14.50), Manchester Triage category 1-2 OR 5.01 (95% CI 1.19, 21.10), low-energy levels OR 3.97 (95% CI 1.32, 11.9) and presenting with cardiac OR 3.59 (95% CI 1.05, 12.3), neurological OR 4.47 (95% CI 1.21, 16.5) or respiratory-related conditions OR 11.2 (95% CI 2.41, 51.9). Among the cohort of discharged patients, 20-30% shared similar physical and mental health characteristics to admitted patients. CONCLUSION: In this elderly population, health-related variables were the only independent factors associated with hospital admission. Approximately 30% of patients discharged home from ED had similar risk profiles to admitted patients.

U2 - 10.1097/MEJ.0b013e32833943d3

DO - 10.1097/MEJ.0b013e32833943d3

M3 - Article

C2 - 20431485

SN - 0969-9546

VL - 18

SP - 19

EP - 24

JO - European Journal of Emergency Medicine

JF - European Journal of Emergency Medicine

IS - 1

ER -