Association between time to geriatric ward admission and change in functional status in older adults after an emergency department visit: a prospective cohort study

The impact of total time from emergency department (ED) admission to geriatric ward admission in older patients remains unknown. The objective of the study was to assess the association between time to geriatric ward admission on 6-month mortality and functional decline in older adults. A prospective, single-center cohort study was conducted including patients 75 years or older admitted to an acute-care geriatric unit following an ED visit in 2023 with a 6-month follow-up. Functional decline was defined as a decrease of at least 1 point in the Activities of Daily Living (ADL) scale between admission and 6 months. The primary end point was a composite of 6-month mortality and functional decline. Association between quartiles of time to geriatric ward admission and the primary end point was analyzed using multivariable logistic regression. Among the 360 included patients (median age 86, median time to geriatric ward admission 32.2 h), 198 (55%) experienced the composite outcome (31% death and 24% functional decline): 42%, 47%, 60%, and 71% in the first to last quartile, respectively. Compared to the first quartile, there was an independent association between time to geriatric ward admission and the primary outcome with an adjusted odds ratios of 1.4 (95% CI 0.8-2.7), 2.3 (95% CI 1.2-4.3), and 3.4 (95% CI 1.8-6.6) for the second, third, and fourth quartiles, respectively. Prolonged time to geriatric ward admission following ED consultation is associated with a higher risk of 6-month mortality and functional decline in older adults.Trial registration 2023-A02753-42 (CPP Sud-Est V approval).