Department of Family Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 81346, Taiwan.
Arch Gerontol Geriatr. 2009 Dec;49 Suppl 2:S32-6. doi: 10.1016/S0167-4943(09)70010-X.
The first presentation of elderly people in the emergency department (ED) is commonly nonspecific and atypical, often in the form of geriatric syndromes, i.e. falls, immobility, incontinence, or deteriorating mental function. The purpose of this study was to evaluate the management and outcomes of institutionalized elderly people who initially presented with geriatric syndrome (GS) in the ED. A retrospective chart review of Banciao Veterans Care Home residents who visited the ED of a tertiary medical center was done. Demographic data including age, sex, modes of arrival, category of triage, time of visit, main presenting symptoms, principal diagnosis, medical expenditures, and clinical outcomes were recorded. From January to December, 2006, 629 ED visits (mean age, 82.1+/-5.3 years, all male) were retrieved. The overall prevalence of GS was 23.8%. When GS subjects were admitted, they were more likely to be transferred to step-down community hospitals for post-acute care (OR = 2.63; 95% CI: 1.36-5.08, p = 0.004). GS was common in institutionalized elderly people calling for ED services, and GS subjects were more likely to be transferred to step-down community hospitals after hospitalization. Comprehensive geriatric assessments may be of value for institutionalized elderly patients visiting the ED.
老年人在急诊科（ED）的首次就诊通常是非特异性和非典型的，通常表现为老年综合征，即跌倒、活动能力丧失、失禁或精神功能恶化。本研究旨在评估最初在急诊科出现老年综合征（GS）的住院老年人的治疗和结局。对一家三级医疗中心 ED 就诊的板桥区荣民之家居民进行了回顾性图表审查。记录了人口统计学数据，包括年龄、性别、到达方式、分诊类别、就诊时间、主要症状、主要诊断、医疗费用和临床结局。2006 年 1 月至 12 月，共检索到 629 例 ED 就诊（平均年龄 82.1+/-5.3 岁，均为男性）。GS 的总体患病率为 23.8%。当 GS 患者入院时，他们更有可能被转至降阶梯社区医院进行急性后护理（OR=2.63；95%CI：1.36-5.08，p=0.004）。老年综合征在呼叫 ED 服务的住院老年人中很常见，住院后 GS 患者更有可能被转至降阶梯社区医院。对住院的老年患者进行全面的老年评估可能具有一定价值。
