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Miró Ò, Jacob J, García-Lamberechts EJ, Piñera Salmerón P, Llorens P, Jiménez S, Burillo-Putze G, Montero-Pérez FJ, Aguiló S, Gil-Rodrigo A, Fernández Alonso C, Alquézar-Arbé A, Parra-Esquivel P, Fortuny Bayarri MJ, González Tejera M, Millán Soria J, Cirera I, Adroher M, Martín Mojarro E, Gargallo García E, Valle B, Díaz Salado Á, Ruiz Grispán M, López Díez MP, Beddar Chaib F, Salido Mota M, Pedraza García J, Sánchez Sindín G, Juárez González R, Pérez Costa RA, Escudero Sánchez C, Prieto Zapico A, González Del Castillo J. Sociodemographic characteristics, functional status, and health resource use of older patients treated in Spanish emergency departments: a description of the EDEN cohort. Emergencias 2022; 34:418-427. [PMID: 36625691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVES To describe the sociodemographic characteristics of and the health care resources used to treat patients aged 65 years or older who come to hospital emergency departments (EDs) in Spain, according to age groups. MATERIAL AND METHODS We studied the phase-1 data for the EDEN cohort (Emergency Department and Elder Needs). Forty Spanish EDs collected data on all patients aged 65 years or older who were treated on the first 7 days in April 2019. We registered information on 6 sociodemographic and 5 function variables for all patients. For health resource use we used 6 diagnostic, 13 therapeutic, and 5 physical structural variables, for a total of 24 variables. Differences were analyzed according to age in blocks of 5 years. RESULTS A total of 18 374 patients with a median age of 78 years were included; 55% were women. Twenty-seven percent arrived by ambulance, 71% had not previously been seen by a physician, and 13% lived alone without assistance. Ten percent had a high level of functional dependence, and 14% had serious comorbidity. Resources used most often were blood analysis (in 60%) and radiology (59%), analgesics (25%), intravenous fluids (21%), antibiotics (14%), oxygen (13%), and bronchodilators (11%). Twenty-six percent were kept under observation in the ED, 26% were admitted to wards, and 2% were admitted to intensive care units (ICUs). The median stay in the ED was 3.5 hours, and the median hospital stay was 7 days. Sociodemographic characteristics changed according to age. Functional dependence worsened with age, and resource requirements increased in general. However, benzodiazepine use was unaffected, while the use of nonsteroidal anti-inflammatory drugs and ICU admission decreased. CONCLUSION The functional dependence of older patients coming to EDs increases with age and is associated with a high level of health care resource use, which also increases with age. Planners should take into consideration the characteristics of the older patients and the proportion of the caseload they represent when arranging physical spaces and designing processes for a specific ED.
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Affiliation(s)
- Òscar Miró
- Área de Urgencias, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, España
| | - Javier Jacob
- Servicio de Urgencias, Hospital Universitari de Bellvitge, l'Hospitalet de Llobregat, Barcelona, España
| | | | | | - Pere Llorens
- Servicio de Urgencias, Unidad de Estancia Corta y Hospitalización a Domicilio, Hospital Doctor Balmis, Instituto de Investigación Sanitaria y Biómedica de Alicante (ISABIAL), Universidad Miguel Hernández, Alicante, España
| | - Sònia Jiménez
- Área de Urgencias, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, España
| | | | | | - Sira Aguiló
- Área de Urgencias, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, España
| | - Adriana Gil-Rodrigo
- Servicio de Urgencias, Unidad de Estancia Corta y Hospitalización a Domicilio, Hospital Doctor Balmis, Instituto de Investigación Sanitaria y Biómedica de Alicante (ISABIAL), Universidad Miguel Hernández, Alicante, España
| | - Cesáreo Fernández Alonso
- Servicio de Urgencias, Hospital Clínico San Carlos, IDISSC, Universidad Complutense, Madrid, España
| | - Aitor Alquézar-Arbé
- Servicio de Urgencias, Hospital de la Santa Creu i Sant Pau, Barcelona, España
| | | | | | | | - Javier Millán Soria
- Servicio de Urgencias, Hospital Universitario y Politécnico La Fe, Valencia, España
| | - Isabel Cirera
- Servicio de Urgencias, Hospital del Mar, Barcelona, España
| | - María Adroher
- Servicio de Urgencias, Hospital Doctor Josep Trueta, Girona, España
| | | | | | - Beatriz Valle
- Servicio de Urgencias, Hospital Universitario Severo Ochoa, Leganés, Madrid, España
| | - Ángel Díaz Salado
- Servicio de Urgencias, Hospital Universitario Infanta Cristina, Parla, Madrid, España
| | | | | | | | - Manuel Salido Mota
- Servicio de Urgencias, Hospital Regional Universitario de Málaga, Málaga, España
| | - Jorge Pedraza García
- Servicio de Urgencias, Hospital Valle de los Pedroches, Pozoblanco, Córdoba, España
| | | | - Ricardo Juárez González
- Servicio de Urgencias, Hospital Nuestra Señora del Prado, Talavera de la Reina, Toledo, España
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