The impact of geriatricians in the emergency department: A prospective observational study

IF 1.4 4区医学 Q4 GERIATRICS & GERONTOLOGY

Australasian Journal on Ageing Pub Date : 2025-03-24 DOI:10.1111/ajag.13405

Anvesh Jackson, Reza Pazhang, Rosa C. Gualano, Helen Psihogios, Rachel Rosler, Sumitha Bhaskaran

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引用次数: 0

Abstract

Objectives

The primary aim of this study was to evaluate the impacts of an emergency department (ED)-embedded geriatric service in redirecting older adults from an acute inpatient hospital admission through a targeted assessment by a geriatrician in ED (GED). Secondary aims were to describe the utilisation of local community health and outpatient services to successfully redirect older patients from an acute hospital admission and determine the re-attendance rates of patients to ED within 28 days after initial presentation.

Methods

This was a prospective observational study performed in two stages due to COVID-19-related interruption. All referrals by ED physicians related to older adults with geriatric syndromes were reviewed by GED. Of these patients, those with a planned disposition for an inpatient admission were included in the primary and secondary analysis of this study.

Results

A total of 273 patients were seen by GED. More than half of older adults (n = 147) planned for inpatient admission were directly discharged from ED. The failure rate, defined by older adults re-presenting to ED within 28 days with the same initial complaint and needing hospital admission, totalled 4%. Comorbid frailty, cognitive impairment and polypharmacy were common.

Conclusion

Evaluation of older adults presenting to ED by a geriatrician facilitates safe hospital admission prevention.

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老年病学医生对急诊科的影响：前瞻性观察研究

本研究的主要目的是通过急诊科（ED）的老年专科医生的目标评估，评估嵌入急诊科（ED）的老年服务对从急性住院住院的老年人重新定向的影响。次要目的是描述当地社区卫生和门诊服务的利用情况，以成功地将老年患者从急性住院转移到医院，并确定患者在初次就诊后28天内再次到急诊室就诊的比率。方法本研究是一项前瞻性观察性研究，由于covid -19相关中断，分两个阶段进行。所有与老年综合征老年人相关的ED医生的转诊均由GED审查。在这些患者中，那些计划住院的患者被纳入本研究的主要和次要分析。结果共检查273例患者。超过一半的计划住院的老年人（n = 147）直接从急诊科出院。失败率，定义为老年人在28天内再次出现在急诊科，最初的抱怨相同，需要住院，总计4%。合并症虚弱，认知障碍和多药是常见的。结论由老年病专家对急诊科就诊的老年人进行评估有助于安全住院预防。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Australasian Journal on Ageing 医学-老年医学

CiteScore

3.10

自引率

6.20%

发文量

114

审稿时长

>12 weeks

期刊介绍： Australasian Journal on Ageing is a peer reviewed journal, which publishes original work in any area of gerontology and geriatric medicine. It welcomes international submissions, particularly from authors in the Asia Pacific region.