Furlong Kayla Rose, O'Donnell Kathleen, Farrell Alison, Mercer Susan, Norman Paul, Parsons Michael, Patey Christopher
Discipline of Family Medicine, Faculty of Medicine, Memorial University, St John's, NL, Canada.
Discipline of Emergency Medicine, Faculty of Medicine, Memorial University, St John's, NL, Canada.
JMIR Res Protoc. 2023 Mar 15;12:e38246. doi: 10.2196/38246.
Older adults have a higher visit rate and poorer health outcomes in the emergency department (ED) compared to their younger counterparts. Older adults are more likely to require additional resources and hospital admission. The nonspecific, atypical, and complex nature of disease presentation in older adults challenges current ED triage systems. Acute illness in older adults is often missed or commonly disguised in the ED as a social or functional issue. If diagnostic clarity is lacking or safe discharge from the ED is not feasible, then older adults may be labelled a "social admission" (or another synonymous term), often leading to negative health consequences.
This scoping review aims to describe and synthesize the available evidence on patient characteristics, adverse events, and health outcomes for older adults labelled as "social admission" (and other synonymously used terms), as well as those with nonacute or nonspecific complaints in the ED or hospital setting.
A literature search of MEDLINE, Embase, Scopus, PsycINFO, and CINAHL was completed. Relevant reference lists were screened. Data have been managed using EndNote software and the Covidence web application. Original data have been included if patients are aged ≥65 years and are considered a "social admission" (or other synonymously used term) or if they present to the ED with a nonacute or nonspecific complaint. Two review team members have reviewed titles and abstracts and will review full-text articles. Disagreements are resolved by consensus or in discussion with a third reviewer. This review does not require research ethics approval.
As of January 2023, we have completed the title and abstract screening and have started the full-text screening. Some remaining full-text articles are being retrieved and/or translated. We are extracting data from included studies. Data will be presented in a narrative and descriptive manner, summarizing key concepts, patient characteristics, and health outcomes of patients labelled as a "social admission" (and other synonymously used terms) and of those with nonacute and nonspecific complaints. We expect the first results for publication in Spring 2023.
Acute illness in the older adult is not always easily identified. We hope to better understand patient characteristics, adverse events, and health outcomes of older adults labelled as a "social admission," as well as those with nonacute or nonspecific complaints. We aim to identify priorities for future research and identify knowledge gaps that may inform health care providers caring for these vulnerable patients.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/38246.
与年轻患者相比，老年人在急诊科的就诊率更高，健康结局更差。老年人更有可能需要额外的资源和住院治疗。老年人疾病表现的非特异性、非典型性和复杂性对当前的急诊科分诊系统构成了挑战。老年人的急性疾病在急诊科常被漏诊或通常被伪装成社会或功能问题。如果缺乏诊断清晰度或无法从急诊科安全出院，那么老年人可能会被贴上“社会住院”（或其他同义术语）的标签，这往往会导致负面的健康后果。
本范围综述旨在描述和综合关于被标记为“社会住院”（以及其他同义使用的术语）的老年人以及在急诊科或医院环境中患有非急性或非特异性主诉的患者的患者特征、不良事件和健康结局的现有证据。
完成了对MEDLINE、Embase、Scopus、PsycINFO和CINAHL的文献检索。对相关参考文献列表进行了筛选。使用EndNote软件和Covidence网络应用程序管理数据。如果患者年龄≥65岁且被视为“社会住院”（或其他同义使用的术语），或者他们因非急性或非特异性主诉就诊于急诊科，则纳入原始数据。两名综述团队成员对标题和摘要进行了审查，并将对全文进行审查。分歧通过协商一致或与第三位审查员讨论解决。本综述无需研究伦理批准。
截至2023年1月，我们已完成标题和摘要筛选，并已开始全文筛选。一些剩余的全文文章正在检索和/或翻译中。我们正在从纳入的研究中提取数据。数据将以叙述性和描述性的方式呈现，总结被标记为“社会住院”（以及其他同义使用的术语）的患者以及患有非急性和非特异性主诉的患者的关键概念、患者特征和健康结局。我们预计2023年春季公布首批结果。
老年人的急性疾病并不总是容易识别。我们希望更好地了解被标记为“社会住院”的老年人以及患有非急性或非特异性主诉的老年人的患者特征、不良事件和健康结局。我们旨在确定未来研究的重点，并识别可能为照顾这些脆弱患者的医疗保健提供者提供信息的知识差距。
国际注册报告识别码（IRRID）：DERR1-10.2196/38246。
