Bannelier Héloïse, Zerah Lorène, Catoire Pierre, Phagouapé Justine, Guyot Salomé, Freund Yonathan, Minaud Alix, Boddaert Jacques, Dauny Vincent, Philippon Anne-Laure
Emergency Department, Pitié Salpêtrière Hospital, 83 Boulevard de L'Hôpital, 75013, Paris, France.
Sorbonne Université, IMProving Emergency Care FHU, Paris, France.
Intern Emerg Med. 2025 Apr 14. doi: 10.1007/s11739-025-03909-3.
The impact of total time from emergency department (ED) admission to geriatric ward admission in older patients remains unknown. The objective of the study was to assess the association between time to geriatric ward admission on 6-month mortality and functional decline in older adults. A prospective, single-center cohort study was conducted including patients 75 years or older admitted to an acute-care geriatric unit following an ED visit in 2023 with a 6-month follow-up. Functional decline was defined as a decrease of at least 1 point in the Activities of Daily Living (ADL) scale between admission and 6 months. The primary end point was a composite of 6-month mortality and functional decline. Association between quartiles of time to geriatric ward admission and the primary end point was analyzed using multivariable logistic regression. Among the 360 included patients (median age 86, median time to geriatric ward admission 32.2 h), 198 (55%) experienced the composite outcome (31% death and 24% functional decline): 42%, 47%, 60%, and 71% in the first to last quartile, respectively. Compared to the first quartile, there was an independent association between time to geriatric ward admission and the primary outcome with an adjusted odds ratios of 1.4 (95% CI 0.8-2.7), 2.3 (95% CI 1.2-4.3), and 3.4 (95% CI 1.8-6.6) for the second, third, and fourth quartiles, respectively. Prolonged time to geriatric ward admission following ED consultation is associated with a higher risk of 6-month mortality and functional decline in older adults.Trial registration 2023-A02753-42 (CPP Sud-Est V approval).
老年患者从急诊科入院到老年病房入院的总时长所产生的影响尚不清楚。本研究的目的是评估老年病房入院时间与老年人6个月死亡率及功能衰退之间的关联。我们进行了一项前瞻性、单中心队列研究，纳入了2023年因急诊就诊后入住急性护理老年病房且年龄在75岁及以上的患者，并进行了6个月的随访。功能衰退定义为入院时与6个月时日常生活活动（ADL）量表得分至少下降1分。主要终点是6个月死亡率和功能衰退的综合指标。使用多变量逻辑回归分析老年病房入院时间四分位数与主要终点之间的关联。在纳入的360例患者中（中位年龄86岁，老年病房入院中位时间32.2小时），198例（55%）出现了综合结局（31%死亡，24%功能衰退）：第一至第四四分位数分别为42%、47%、60%和71%。与第一四分位数相比，老年病房入院时间与主要结局之间存在独立关联，第二、第三和第四四分位数的调整比值比分别为1.4（95%可信区间0.8至2.7）、2.3（95%可信区间1.2至4.3）和3.4（95%可信区间1.8至6.6）。急诊会诊后老年病房入院时间延长与老年人6个月死亡率和功能衰退风险较高相关。试验注册号2023 - A02753 - 42（法国东南部CPP批准）
