Elderly patients in the emergency department

Eliastam, Michael

doi:10.1016/s0196-0644(89)80064-2

Cited by 56 publications

(23 citation statements)

References 26 publications

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“…Another variable that we examined was LOS in the ED. This variable was reported in only a few of the studies, 8,15,16 where the majority of patients stayed in the ED for only a few hours compared with the mean of 3.7 days in our study. This difference may be a result of differing ratios for number of acute beds per older patient or secondary to more fundamental differences between the American and Canadian health systems.…”

Section: Discussioncontrasting

confidence: 51%

A Two‐Year Follow‐Up of Geriatric Consults in the Emergency Department

Sinoff

Clarfield

Bergman

et al. 1998

J American Geriatrics Society

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The older patients seen in the ED of the acute care hospital for whom multidisciplinary geriatric consult is requested constitute a high-risk population. Within 2 years after initial consultation, many are dead and more than half have been institutionalized. The results of our follow-up imply the need for multidisciplinary intervention early on in the course of an older patient's ED visit as well as close follow-up after hospital discharge.

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Section: Discussioncontrasting

confidence: 51%

A Two‐Year Follow‐Up of Geriatric Consults in the Emergency Department

Sinoff

Clarfield

Bergman

et al. 1998

J American Geriatrics Society

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“…Older adults have been shown to present with: nonstandard disease presentations, altered laboratory values, multiple co-morbid diseases, extensive medical histories, communication problems, altered mental status, and the absence of classic diagnostic symptoms (5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

Older adults in the emergency department: Predicting physicians’ burden levels

Schumacher

Deimling

Meldon

et al. 2006

The Journal of Emergency Medicine

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“…[1][2][3] In addition, their clinical presentation and physical examination may be less reliable. [4][5][6][7][8][9] Previous research has consistently demonstrated that emergency abdominal surgery in elderly patients is associated with increased morbidity and mortality compared with elective surgery or emergency surgery in younger patients. [10][11][12][13][14][15][16][17][18][19][20] Accordingly, the decision to proceed with surgery must be considered carefully.…”

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confidence: 99%

Management and outcomes of small bowel obstruction in older adult patients: a prospective cohort study

et al. 2014

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Background:The purpose of this research was to examine the morbidity, mortality and rate of recurrent bowel obstruction associated with the treatment of small bowel obstruction (SBO) in older adults. Methods:We prospectively enrolled all patients 70 years or older with an SBO who were admitted to a tertiary care teaching centre between Jul. 1, 2011, and Sept. 30, 2012. Data regarding presentation, investigations, treatment and outcomes were collected. Results:Of the 104 patients admitted with an SBO, 49% were managed nonoperatively and 51% underwent surgery. Patients who underwent surgery experienced more complications (64% v. 27%, p = 0.002) and stayed in hospital longer (10 v. 3 d, p < 0.001) than patients managed nonoperatively. Nonoperative management was associated with a high rate of recurrent SBO: 31% after a median follow-up of 17 months. Of the patients managed operatively, 60% underwent immediate surgery and 40% underwent surgery after attempted nonoperative management. Patients in whom nonoperative management failed underwent surgery after a median of 2 days, and 89% underwent surgery within 5 days. The rate of bowel resection was high (29%) among those who underwent delayed surgery. Surgery after failed nonoperative management was associated with a mortality of 14% versus 3% for those who underwent immediate surgery; however, this difference was not significant. Conclusion:These data suggest that some elderly patients with SBO may be waiting too long for surgery.Contexte : Le but de cette recherche était d'analyser la morbidité, la mortalité et le taux de récurrence de l'occlusion intestinale associés au traitement de l'occlusion intestinale grêle (OIG) chez des adultes âgés.Méthodes : Nous avons inscrit de manière prospective tous les patients de 70 ans ou plus présentant une OIG qui ont été admis dans un établissement de soins tertiaires entre le 1er juillet 2011 et le 30 septembre 2012. Nous avons recueilli les données concernant les tableaux cliniques, les épreuves diagnostiques, les traitements et leurs résultats. Résultats :Parmi les 104 patients admis pour OIG, 49 % ont été traités non chirurgicalement et 51 % ont subi une intervention chirurgicale. Les patients soumis à la chirurgie ont présenté davantage de complications (64 % c. 27 %, p = 0,002) et ont séjourné plus longtemps à l'hôpital (10 j. c. 3 j., p < 0,001) comparativement aux patients qui n'ont pas été opérés. La prise en charge non chirurgicale a été associée à un taux élevé de récurrences de l'OIG : 31 % après un suivi médian de 17 mois. Parmi les patients opérés, 60 % ont subi une chirurgie immédiate et 40 % ont subi leur chirurgie après une tentative de prise en charge non chirurgicale. Les patients chez qui la prise en charge non chirurgicale a échoué ont subi leur chirurgie après une période médiane de 2 jours et 89 % en l'espace de 5 jours. Le taux de résection intestinale a été élevé (29 %) chez ceux dont la chirurgie a été retardée. La chirurgie après une intervention non chirurgicale infructueuse a été associée à un taux d...

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Elderly patients in the emergency department

Cited by 56 publications

References 26 publications

A Two‐Year Follow‐Up of Geriatric Consults in the Emergency Department

A Two‐Year Follow‐Up of Geriatric Consults in the Emergency Department

Older adults in the emergency department: Predicting physicians’ burden levels

Management and outcomes of small bowel obstruction in older adult patients: a prospective cohort study

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