Evaluation of the general characteristics of patients aged 85 years and above admitted to a university hospital emergency department

Abstract

Background/aim: The number of elderly people (≥65 years old) is increasing both in Turkey and internationally due to improved living conditions and decreased mortality rates. Knowing the characteristics of elderly patients admitted to emergency departments can provide guidance for diagnosis and treatment approaches. In this study, we analyzed the characteristics of very old patients (≥85 years old) admitted to the emergency department and put together data for use in forward planning in healthcare services. Materials and methods:This retrospective study included all patients aged ≥85 years admitted to the Adult Emergency Department of Gazi University Medical Faculty Hospital between 01.01.2014 and 31.12.2014. Data concerning the patients' age, sex, date of admission, weekday or weekend admission, reason for admission, length of stay, number of readmissions, admission from within or outside the province, and whether they were hospitalized or not were evaluated.Results: In this study, 1105 admissions of 780 patients aged ≥85 years to the emergency department were analyzed. The median age of the patients was 87 years and 59% were female. The most frequent admissions were in January (11.4%). Most patients (63.1%) were admitted only once to our emergency department within the study period. A total of 40.5% of patients were hospitalized in the clinics or intensive care units. The rate of mortality at first admission was 1.5% (12 patients). The most common complaints at admission were infection (13.3%) and soft tissue traumas (crashes, sprains, fractures, dislocations) related to the musculoskeletal system (11.8%). Readmissions were more frequent in males. It was seen that male patients were more frequently admitted due to deterioration of general health status and genitourinary system symptoms, despite pain being more common among women. Conclusion:Due to the changing population structure, emergency staff in Turkey as well as internationally encounter old and very old patients more frequently. It is now imperative that emergency departments acquire the necessary infrastructure, human resources, knowledge, and equipment needed to meet the needs of these patients.

Characteristics of the Admissions of Old-old Patients to the Emergency Department

“…Considering the distribution of case admissions by months in our study, it was observed that the most frequent months were December, November and October, respectively. Although there are differences in the literature regarding of the frequent admission months, however it was observed that the geriatric patient group admitted most frequently in autumn and winter season [10,11]. This might be explained by the seasonal flu period starting from mid-autumn to early spring and the resistance of geriatric patients to respiratory infections is different from other age groups.…”

“…The discharge rate of patients who were admitted only once was 84.2% and the rate was 88.4% for twice and more admissions. In the study of Demircan et al, they mentioned that the re-application rate was 37% in one-year period [11], in another study, this rate was reported as 50% [6]. Patients whose acute treatment is completed in the emergency department and have no indication for hospitalization should be followed by appropriate polyclinics or home care services.…”

An Evidence Review of Ageing, Long-Term Care Provision and Funding Mechanisms in Turkey: Using Existing Evidence to Estimate Long-Term Care Cost

“…Alzheimer's disease and other forms of dementia disproportionally affect people with lower educational attainment who are less likely to be eligible for pensions associated with formal employment [26]. There is also evidence of trends towards extended hospitalisations [27], use of emergency services [28] and the admission of frail, older people to health facilities due to lack of LTC services in the community [29].…”

Evaluation of Admission Causes and Mortality Rates of 65 Years of Age and Older Patients Admitted From the Emergency Department to the Intensive Care Unit

“…In Turkey, according to data of the Turkey Statistics Institute reported in 2016, the number of elderly has increased by 17.1% in the last 5 years, and the proportion of the elderly has reached to 8.3% of the population by the end of 2016 (2). Consistent with this increase in the elderly population, the rate of admission of elderly patients to hospitals, particularly to emergency departments (EDs) and intensive care units (ICUs), is also gradually increasing (3)(4)(5)(6)(7). Admission rates of elderly patients are variable in different countries, cities and regions (4).…”

“…Consistent with this increase in the elderly population, the rate of admission of elderly patients to hospitals, particularly to emergency departments (EDs) and intensive care units (ICUs), is also gradually increasing (3)(4)(5)(6)(7). Admission rates of elderly patients are variable in different countries, cities and regions (4). In addition, the admission rates of elderly patients to EDs vary according to the population and socioeconomic status of the elderly in the city; location and total number of hospitals in the city and characteristics of the hospital, such as bed capacity (5,8).…”