Geriatr Psychol Neuropsychiatr Vieil. 2014 Mar 1;12(1):43-49.

Older adults and emergency department: who is at risk of hospitalization?

Launay C1, Haubois G1, Hureaux-Huynh R1, Gautier J1, Annweiler C2, Beauchet O2.

Author information

• 1Pôle de neurosciences, Service de gériatrie, Centre hospitalo-universitaire d'Angers, France.
• 2Pôle de neurosciences, Service de gériatrie, Centre hospitalo-universitaire d'Angers, France, UPRES EA 4638, Université d'Angers, UNAM, France.

Abstract

Objective: Screening older adults at risk of hospitalisation after an admission in emergency Department (ED) is an objective to be reach. The objective of this study was to examine the association between clinical characteristics (items of brief geriatric assessment (BGA), score of clinical classification of emergency diseases (CCED), diagnosis) and hospital stay in older adults admitted in ED. 

Methods: Based on a prospective cohort study design, 426 elderly patients were assessed in ED using a BGA composed by age, gender, number of drugs daily taken, history of falls during the past 6 months, incorrect orientation for year and month, no caregiver's or relative's help, added to CCED gravity score and principal diagnosis. Hospitalization was defined as a hospital stay of more than 24 hours after admission to the SAU. 

Results: 313 people (72.3%) were hospitalized for more than 24 hours. The prevalence of temporal disorientation was higher in hospitalized patients over 24 hours (p=0.016). Logistic regression models showed that an organ failure with a CCED score other class I (p<0.010), cognitive impairment (p<0.030) and an admission for social problem (p<0,001) were associated with a length of stay longer than 24 hours. 

Conclusions: Our study showed an association between organ failure, neuropsychiatric disorders, social problems and hospitalization after an admission in ED. These clinical characteristics may be useful for the early identification of older patients at risk for complex hospital pathway.