Latham Lesley P, Ackroyd-Stolarz Stacy
Department of Emergency Medicine, Dalhousie University, Halifax, NS.
Can Geriatr J. 2014 Dec 2;17(4):118-25. doi: 10.5770/cgj.17.108. eCollection 2014 Dec.
Emergency Departments (EDs) are playing an increasingly important role in the care of older adults. Characterizing ED usage will facilitate the planning for care delivery more suited to the complex health needs of this population.
In this retrospective cross-sectional study, administrative and clinical data were extracted from four study sites. Visits for patients aged 65 years or older were characterized using standard descriptive statistics.
We analyzed 34,454 ED visits by older adults, accounting for 21.8% of the total ED visits for our study time period. Overall, 74.2% of patient visits were triaged as urgent or emergent. Almost half (49.8%) of visits involved diagnostic imaging, 62.1% involved lab work, and 30.8% involved consultation with hospital services. The most common ED diagnoses were symptom- or injury-related (25.0%, 17.1%. respectively). Length of stay increased with age group (Mann-Whitney U; p < .0001), as did the proportion of visits involving diagnostic testing and consultation (χ(2); p < .0001). Approximately 20% of older adults in our study population were admitted to hospital following their ED visit.
Older adults have distinct patterns of ED use. ED resource use intensity increases with age. These patterns may be used to target future interventions involving alternative care for older adults.
急诊科在老年人护理中发挥着越来越重要的作用。对急诊科的使用情况进行特征描述将有助于规划更适合该人群复杂健康需求的护理服务。
在这项回顾性横断面研究中，从四个研究地点提取了行政和临床数据。使用标准描述性统计方法对65岁及以上患者的就诊情况进行了特征描述。
我们分析了老年人的34454次急诊科就诊，占我们研究时间段内急诊科总就诊次数的21.8%。总体而言，74.2%的患者就诊被分诊为紧急或急症。几乎一半（49.8%）的就诊涉及诊断性影像学检查，62.1%涉及实验室检查，30.8%涉及与医院服务的会诊。最常见的急诊科诊断分别是与症状或损伤相关的（分别为25.0%、17.1%）。住院时间随年龄组增加而延长（曼-惠特尼U检验；p < 0.0001），涉及诊断性检查和会诊的就诊比例也随年龄组增加而增加（χ²检验；p < 0.0001）。在我们的研究人群中，约20%的老年人在急诊科就诊后被收治入院。
老年人有独特的急诊科使用模式。急诊科资源使用强度随年龄增加而增加。这些模式可用于针对未来涉及老年人替代护理的干预措施。
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