Pôle médecine d'urgence, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France.
Gérontopole de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France; Unité Mixe de Recherche, UMR 1027, Université Toulouse III, Toulouse, France.
J Am Med Dir Assoc. 2019 Nov;20(11):1462-1466. doi: 10.1016/j.jamda.2019.07.013. Epub 2019 Aug 30.
There has been an increase in the number of visits by older individuals to emergency departments (EDs). The primary cause of this is trauma. The objective of this study was to evaluate the temporal changes in the use of EDs by older individuals for traumatic injuries, characterize their trauma, and specify the mode of transport to the ED according to their place of residence (community-dwelling or nursing home resident).
A monocentric, retrospective study of patients over 65 years of age, admitted to University Center Hospital ED for trauma between 2013 and 2017.
In total, 20,741 patients were included.
The mean age was 81.8 years (standard deviation 9.1 years); 11,879 (57.3%) patients were community-living with family, 5077 (24.5%) were nursing home (NH) residents, and 3785 (18.22%) patients were community-dwelling living alone. Overall, 33.3% of the NH residents were transferred during the weekend compared with 28.04% of the community-dwelling individuals (P < .001). Ten percent (1577 patients) of the community-dwelling individuals compared with 21.8% (1109 patients) of the transfers of NH residents to ED occurred late at night (P < .001). The primary reason for use of the ED was head trauma (32.0%), followed by cutaneo-mucous wounds (28.7 %) and limb fractures (25.9%). In most cases, NH residents were transferred by ambulance (5000 residents; 98.4%), compared with community-dwelling individuals (11,118; 70.1%; P < .001). Overall, 7459 (36.0 %) patients were hospitalized.
In comparison with community-dwelling individuals, ED transfers of NH residents in the context of trauma-related emergency were higher during after-hour periods, lengthes of stay at the ED were longer, and residents were admitted less to the in hospital.
到急诊科（ED）就诊的老年人数量有所增加。主要原因是创伤。本研究的目的是评估老年人因创伤而到急诊科就诊的时间变化，描述他们的创伤特征，并根据居住地（居住在社区或养老院的居民）确定到急诊科的交通方式。
2013 年至 2017 年期间，对到大学中心医院急诊科就诊的 65 岁以上因创伤患者进行的单中心回顾性研究。
共纳入 20741 例患者。
平均年龄为 81.8 岁（标准差为 9.1 岁）；11879 例（57.3%）为有家庭的社区居住者，5077 例（24.5%）为养老院（NH）居民，3785 例（18.22%）为独居的社区居住者。总体而言，周末 NH 居民的转院率为 33.3%，而社区居住者的转院率为 28.04%（P<.001）。与社区居住者相比，10%（1577 例）的社区居住者和 21.8%（1109 例）的 NH 居民的转院发生在深夜（P<.001）。使用急诊科的主要原因是头部创伤（32.0%），其次是皮肤黏膜伤口（28.7%）和四肢骨折（25.9%）。在大多数情况下，NH 居民由救护车转院（5000 名居民；98.4%），而社区居住者由救护车转院（11118 名；70.1%）（P<.001）。总体而言，7459 例（36.0%）患者住院。
与社区居住者相比，NH 居民因创伤相关紧急情况而转至急诊科的比例在非工作时间更高，在急诊科的停留时间更长，住院治疗的比例更低。
