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欧洲急诊老年患者的流行病学研究:EGERS 研究。

Epidemiology of geriatric patients presenting to emergency departments in Europe: EGERS study.

机构信息

Department of Emergency Medicine, Faculty of Medicine, Gazi University, Ankara.

Division of Emergency and Acute Medicine, Campus Virchow Klinikum and Charité Campus Mitte, Charite Universitatmedizin, Berlin, Germany.

出版信息

Eur J Emerg Med. 2023 Apr 1;30(2):117-124. doi: 10.1097/MEJ.0000000000000997. Epub 2023 Jan 31.

Abstract

BACKGROUND AND IMPORTANCE

Patients aged 65 and above constitute a large and growing part of emergency department (ED) visits in western countries.

OBJECTIVE

The primary aim of this European prospective study was to determine the epidemiologic characteristics of elderly patients presenting to EDs across Europe. Our secondary objective was to determine the hospitalization rate, characteristics, and in-hospital mortality rates of geriatric patients presenting to EDs.

DESIGN SETTING AND PARTICIPANTS

An observational prospective cohort study over seven consecutive days between 19 October and 30 November 2020, in 36 EDs from nine European countries. Patients aged 65 years and older presenting to EDs with any complaint during a period of seven consecutive days were included.

OUTCOME MEASURES

Data were collected on demographics, the major presenting complaint, the presenting vital signs, comorbidities, usual medication, and outcomes after the ED, including disposition, in-hospital outcome, and the final hospital diagnosis. The patients were stratified into three groups: old (65-74 years), older (75-84 years), and oldest age (>85 years).

MAIN RESULTS

A total of 5767 patients were included in the study. The median age of the patients was 77 (interquartile range: 71-84) years. The majority presented with a non-traumatic complaint (81%) and about 90% of the patients had at least one comorbid disease and were on chronic medication. An ED visit resulted in subsequent hospital admission in 51% of cases, with 9% of patients admitted to an intensive care unit. Overall in-hospital mortality was 8%, and ED mortality was 1%. Older age was associated with a higher female proportion, comorbidities, need for home care service, history of previous falls, admission rates, length of ED, and hospital stay.

CONCLUSION

The characteristics of ED elderly patients and their subsequent hospital stay are reported in this prospective study.

摘要

背景与重要性

65 岁及以上的患者在西方国家的急诊科就诊中占很大比例,且这一比例还在不断增长。

目的

这项欧洲前瞻性研究的主要目的是确定欧洲各急诊科就诊老年患者的流行病学特征。我们的次要目的是确定急诊科就诊老年患者的住院率、特征和院内死亡率。

设计、地点和参与者:这是一项观察性前瞻性队列研究,于 2020 年 10 月 19 日至 11 月 30 日连续 7 天在欧洲 9 个国家的 36 个急诊科进行。纳入年龄在 65 岁及以上、因任何主诉在连续 7 天内就诊于急诊科的患者。

观察指标

收集的数据包括人口统计学特征、主要就诊主诉、就诊时生命体征、合并症、常用药物以及急诊科就诊后的结局,包括去向、院内结局和最终的医院诊断。患者分为三组:老年(65-74 岁)、更老年(75-84 岁)和最老年(>85 岁)。

主要结果

共纳入 5767 例患者。患者的中位年龄为 77 岁(四分位距:71-84 岁)。大多数患者因非创伤性主诉就诊(81%),约 90%的患者患有至少一种合并症且正在服用慢性病药物。51%的患者因急诊科就诊而随后住院,其中 9%的患者入住重症监护病房。总的院内死亡率为 8%,急诊科死亡率为 1%。年龄越大,女性比例越高,合并症越多,需要家庭护理服务,有既往跌倒史,住院率越高,急诊科就诊时间和住院时间越长。

结论

本前瞻性研究报道了急诊科老年患者的特征及其随后的住院情况。

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