Department of Health Care for Older People (HCOP), Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, Nottinghamshire, UK.
Department of Research and Education in Emergency Medicine, Acute Medicine and Major Trauma (DREEAM), Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK.
Aging Clin Exp Res. 2022 Nov;34(11):2873-2885. doi: 10.1007/s40520-022-02226-5. Epub 2022 Sep 8.
Younger and older adults attending the Emergency Department (ED) are a heterogeneous population. Longer length of ED stay is associated with adverse outcomes and may vary by age.
To evaluate the associations between age and (1) clinical characteristics and (2) length of ED stay among adults attending ED.
The NOttingham Cohort study in the Emergency Department (NOCED)-a retrospective cohort study-comprises new consecutive ED attendances by adults ≥ 18 years, at a secondary/tertiary care hospital, in 2019. Length of ED stay was dichotomised as < 4 and ≥ 4 h. The associations between age and length of ED stay were analysed by binary logistic regression and adjusted for socio-demographic and clinical factors including triage acuity.
146,636 attendances were analysed; 75,636 (51.6%) resulted in a length of ED stay ≥ 4 h. Attendances of adults aged 65 to 74 years, 75 to 84 years and ≥ 85 years, respectively, had an increased risk (odds ratio (95% confidence interval) of length of ED stay ≥ 4 h of 1.52 (1.45-1.58), 1.65 (1.58-1.72), and 1.84 (1.75-1.93), compared to those of adults 18 to 64 years (all p < 0.001). These findings remained consistent in the subsets of attendances leading to hospital admission and those leading to discharge from ED.
In this real-world cohort study, older adults were more likely to have a length of ED stay ≥ 4 h, with the oldest old having the highest risk. ED target times should take into account age of attendees.
在急诊科（ED）就诊的年轻和老年患者是一个异质群体。较长的 ED 停留时间与不良结局相关，并且可能因年龄而异。
评估年龄与（1）临床特征和（2）成年 ED 就诊者 ED 停留时间之间的关联。
诺丁汉急诊科队列研究（NOCED）-一项回顾性队列研究-包括 2019 年在二级/三级护理医院新连续就诊的≥18 岁成年人。ED 停留时间分为<4 和≥4 小时。使用二元逻辑回归分析年龄与 ED 停留时间之间的关联，并根据社会人口统计学和临床因素（包括分诊 acuity）进行调整。
分析了 146636 次就诊；75636 次（51.6%）的 ED 停留时间≥4 小时。分别为 65 至 74 岁、75 至 84 岁和≥85 岁的成年人就诊，其 ED 停留时间≥4 小时的风险增加（优势比（95%置信区间）为 1.52（1.45-1.58）、1.65（1.58-1.72）和 1.84（1.75-1.93），与 18 至 64 岁的成年人相比（均 p<0.001）。这些发现在导致住院和从 ED 出院的就诊亚组中仍然一致。
在这项真实世界的队列研究中，老年人更有可能 ED 停留时间≥4 小时，而最年长的老年人风险最高。ED 目标时间应考虑到就诊者的年龄。
