Use of diagnostic tests in elderly patients consulting the emergency department. Analysis of the emergency department and elder needs cohort (EDEN-8)

IF 2.1 4区医学 Q2 EMERGENCY MEDICINE

Australasian Emergency Care Pub Date : 2024-07-04 DOI:10.1016/j.auec.2024.06.004

Javier Jacob , Elena Fuentes , Juan González del Castillo , Inmaculada Bajo-Fernández , Aitor Alquezar-Arbé , Eric Jorge García-Lamberechts , Sira Aguiló , Cesáreo Fernández-Alonso , Guillermo Burillo-Putze , Pascual Piñera , Pere Llorens , Sònia Jimenez , Adriana Gil-Rodrigo , Jorge Sánchez Tembleque-Sánchez , Maria Pilar López-Diez , Marta Iglesias-Vela , Rafael Antonio Pérez-Costa , Marién López-Pardo , Rebeca González-González , Marina Carrión-Fernández , Òscar Miró

{"title":"Use of diagnostic tests in elderly patients consulting the emergency department. Analysis of the emergency department and elder needs cohort (EDEN-8)","authors":"Javier Jacob , Elena Fuentes , Juan González del Castillo , Inmaculada Bajo-Fernández , Aitor Alquezar-Arbé , Eric Jorge García-Lamberechts , Sira Aguiló , Cesáreo Fernández-Alonso , Guillermo Burillo-Putze , Pascual Piñera , Pere Llorens , Sònia Jimenez , Adriana Gil-Rodrigo , Jorge Sánchez Tembleque-Sánchez , Maria Pilar López-Diez , Marta Iglesias-Vela , Rafael Antonio Pérez-Costa , Marién López-Pardo , Rebeca González-González , Marina Carrión-Fernández , Òscar Miró","doi":"10.1016/j.auec.2024.06.004","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>Analyse the association between the use of diagnostic tests and the characteristics of older patients 65 years of age or more who consult the emergency department (ED).</div></div><div><h3>Methods</h3><div>We performed an analysis of the EDEN cohort that includes patients who consulted 52 Spanish EDs. The association of age, sex, and ageing characteristics with the use of diagnostic tests (blood tests, electrocardiogram (ECG), microbiological cultures, X-ray, computed tomography, ultrasound, invasive techniques) was studied. The association was analysed by calculating the adjusted odds ratios (aOR) and their 95 % confidence intervals (CI) using a logistic regression model.</div></div><div><h3>Results</h3><div>A total of 25,557 patients were analysed. There was an increase in the use of diagnostic tests based on age, with an aOR for blood test of 1.805 (95 %CI 1.671 – 1.950), ECG 1.793 (95 %CI 1.664 – 1.932) and X-ray 1.707 (95 %CI 1.583 – 1.840) in the group of 85 years or more. The use of diagnostic tests is lower in the female population. Most ageing characteristics (cognitive impairment, previous falls, polypharmacy, dependence, and comorbidity) were independently associated with increased use of diagnostic tests.</div></div><div><h3>Conclusions</h3><div>Age, and the characteristics of ageing itself are generally associated with a greater use of diagnostic tests in the ED.</div></div>","PeriodicalId":55979,"journal":{"name":"Australasian Emergency Care","volume":"27 4","pages":"Pages 268-275"},"PeriodicalIF":2.1000,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Australasian Emergency Care","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2588994X2400040X","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}

引用次数: 0

Abstract

Objective

Analyse the association between the use of diagnostic tests and the characteristics of older patients 65 years of age or more who consult the emergency department (ED).

Methods

We performed an analysis of the EDEN cohort that includes patients who consulted 52 Spanish EDs. The association of age, sex, and ageing characteristics with the use of diagnostic tests (blood tests, electrocardiogram (ECG), microbiological cultures, X-ray, computed tomography, ultrasound, invasive techniques) was studied. The association was analysed by calculating the adjusted odds ratios (aOR) and their 95 % confidence intervals (CI) using a logistic regression model.

Results

A total of 25,557 patients were analysed. There was an increase in the use of diagnostic tests based on age, with an aOR for blood test of 1.805 (95 %CI 1.671 – 1.950), ECG 1.793 (95 %CI 1.664 – 1.932) and X-ray 1.707 (95 %CI 1.583 – 1.840) in the group of 85 years or more. The use of diagnostic tests is lower in the female population. Most ageing characteristics (cognitive impairment, previous falls, polypharmacy, dependence, and comorbidity) were independently associated with increased use of diagnostic tests.

Conclusions

Age, and the characteristics of ageing itself are generally associated with a greater use of diagnostic tests in the ED.

查看原文本刊更多论文

在急诊科就诊的老年患者中使用诊断测试。急诊科和老年人需求队列（EDEN-8）分析。

目的分析诊断测试的使用与急诊科（ED）就诊的 65 岁及以上老年患者特征之间的关联：我们对包括 52 家西班牙急诊室就诊患者在内的 EDEN 队列进行了分析。我们研究了年龄、性别和老龄化特征与使用诊断测试（血液测试、心电图、微生物培养、X 光、计算机断层扫描、超声波、侵入性技术）之间的关联。通过使用逻辑回归模型计算调整后的几率比（aOR）及其 95 % 的置信区间（CI）来分析两者之间的关联：结果：共对 25 557 名患者进行了分析。年龄越大，诊断检测的使用率越高，85 岁及以上人群的血液检测 aOR 为 1.805（95 %CI 1.671 - 1.950），心电图 aOR 为 1.793（95 %CI 1.664 - 1.932），X 光 aOR 为 1.707（95 %CI 1.583 - 1.840）。女性使用诊断测试的比例较低。大多数老龄化特征（认知障碍、既往跌倒、多种药物治疗、依赖性和合并症）与诊断检测使用率的增加有独立关联：结论：年龄和老龄化本身的特征通常与急诊室诊断检测的使用增加有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Australasian Emergency Care Nursing-Emergency Nursing

CiteScore

3.30

自引率

5.60%

发文量

审稿时长

37 days

期刊介绍： Australasian Emergency Care is an international peer-reviewed journal dedicated to supporting emergency nurses, physicians, paramedics and other professionals in advancing the science and practice of emergency care, wherever it is delivered. As the official journal of the College of Emergency Nursing Australasia (CENA), Australasian Emergency Care is a conduit for clinical, applied, and theoretical research and knowledge that advances the science and practice of emergency care in original, innovative and challenging ways. The journal serves as a leading voice for the emergency care community, reflecting its inter-professional diversity, and the importance of collaboration and shared decision-making to achieve quality patient outcomes. It is strongly focussed on advancing the patient experience and quality of care across the emergency care continuum, spanning the pre-hospital, hospital and post-hospital settings within Australasia and beyond.