Today's Problem Tomorrow's Crisis: A Retrospective, Single-Centre Observational Study of Nonagenarians in the Emergency Department.

Purpose Our aim was to analyse the Emergency Department (ED) admissions of patients aged 90 years and older (nonagenarians) and to provide the literature with data showing the needs and characteristics of this highly vulnerable group in the ED. Methods This was a retrospective, single-centre observational study from Türkiye. A total of 18,225 patients aged 65 years and older, who were admitted to the ED between January 1, 2022, and December 31, 2023, were identified and included in the study. The characteristics of the long-livers and patients aged less than 90 years were compared with each other. Continuous data were compared between the two groups by the Mann-Whitney U test. The relationships between two categorical variables were analysed by Pearson's Chi-square test. Results The proportion of long-livers among elderly patients was 3.9% (n = 711). A total of 77.6% (n = 552) of the long-livers were admitted by ambulance. The 48-hour, 30-day, and 180-day mortality rates of long-livers were greater than those of elderly patients under 90 years of age: 1.4% (n = 10) vs. 0.4% (n = 69), 5.8% (n = 41) vs. 2% (n = 352), and 10.5% (n = 75) vs. 4.9% (n = 858). The most common diagnoses in the ED are falls, upper respiratory tract infections, and asthma/chronic obstructive pulmonary disease (COPD) attacks. Conclusions The mortality rate of long-livers is quite high, and the decision to discharge patients from the ED should be made with extreme caution. Precautions to be taken about falls may prevent injuries. The establishment of geriatric EDs, and the allocation of vehicles to be used for hospital admissions of long-livers, will reduce the development of ED crowding in the future.