Kaeley Nidhi, Kumar Jainendra, Kumar Manish, Vempalli Nagasubramanyam, Dhar Mridul, Bhardwaj Bharat B, Kumar Subodh, Kabi Ankita, Arora Poonam
Department of Emergency Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
Department of Medicine, Government Doon Medical College, Dehradun, Uttarakhand, India.
J Family Med Prim Care. 2021 Oct;10(10):3899-3903. doi: 10.4103/jfmpc.jfmpc_2450_20. Epub 2021 Nov 5.
Changing demographic patterns worldwide and improvement in healthcarehas contributed to increasing visits to the emergency department byelderly patients. Geriatric patients usually have multiple co-morbidities and declining physiological functional status. This complex interplay of various factors requires a specific and curated approach from the emergency physicians. Our aim was to study the pattern and prevalence of geriatric emergencies and the profile of infectious and non-infectious causes of fever in geriatric population in our tertiary care center.
This retrospective descriptive study was carried out at a tertiary care hospital of north India and included all patients aged more than 18 years who visited the emergency department over a period of six months (July 2018 to December 2018). Detailed data regarding demographic, clinical and diagnosis was obtained retrospectively from the hospital records system. The patients were divided into two groups, age less than 60 years and elderly patients more than 60 years of age for comparison.
A total of 24768 patients above the age of 18 years visited the emergency department over a period of six months. Out of which 5399 (27.5%) patients belonged to the geriatric age group more than 60 years of age. 2474 (45.8%) geriatric age group patientswere triaged to critical areas level one and level two as compared to 4668 (24.1%) patients aged less than 60 years. Ninety (1.8%) geriatric patients succumbed to death as compared to 77 (0.4%) patients aged less than 60 years. 651 (21.9%) geriatric patients were shifted to intensive care unit as opposed to 1038 (14.8%) patients of the younger age group.226 (4.2%) geriatric patients presented with fever in the emergency department.116 (73.4%) patients having underlying co-morbidities , had fever due to infectious causes whereas 42 ( 26.5%) patients had fever due to non-infectious causes.
The clinical presentation mortality and morbidity pattern of geriatric patients differs significantly from that of younger population and requires a customized approach and dedicated emergency setups.
全球人口结构的变化以及医疗保健的改善导致老年患者到急诊科就诊的次数增加。老年患者通常患有多种合并症，生理功能状态不断下降。各种因素的这种复杂相互作用需要急诊医生采取特定的、精心策划的方法。我们的目的是研究老年急诊的模式和患病率，以及我们三级医疗中心老年人群发热的感染性和非感染性原因的概况。
这项回顾性描述性研究在印度北部的一家三级医疗医院进行，纳入了所有在六个月期间（2018年7月至2018年12月）到急诊科就诊的18岁以上患者。有关人口统计学、临床和诊断的详细数据是从医院记录系统中回顾性获取的。将患者分为两组，年龄小于60岁的患者和年龄大于60岁的老年患者进行比较。
在六个月期间，共有24768名18岁以上的患者到急诊科就诊。其中5399名（27.5%）患者属于60岁以上的老年年龄组。与4668名（24.1%）年龄小于60岁的患者相比，2474名（45.8%）老年年龄组患者被分诊到一级和二级关键区域。90名（1.8%）老年患者死亡，而77名（0.4%）年龄小于60岁的患者死亡。651名（21.9%）老年患者被转入重症监护病房，而年龄较小的患者组有1038名（14.8%）。226名（4.2%）老年患者在急诊科出现发热。116名（73.4%）有潜在合并症的患者因感染性原因发热，而42名（26.5%）患者因非感染性原因发热。
老年患者的临床表现、死亡率和发病率模式与年轻人群有显著差异，需要定制的方法和专门的急诊设置。
