Emergency department attendance stratified by cause and frailty status: A national retrospective cohort study

IF 2.5 4区医学 Q3 GERIATRICS & GERONTOLOGY

Geriatrics & Gerontology International Pub Date : 2025-08-28 DOI:10.1111/ggi.70153

Balamrit Singh Sokhal, Andrija Matetić, Joanne Protheroe, Toby Helliwell, Phyo K. Myint, Timir K. Paul, Christian D. Mallen, Mamas A. Mamas

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引用次数: 0

Abstract

Aim

The aim of this study was to determine whether the causes of emergency department (ED) attendance and clinical outcomes vary by frailty status.

Methods

Using the Nationwide ED Sample, causes of attendance were stratified by Hospital Frailty Risk Score (HFRS). Logistic regression was used to determine adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) of ED and overall mortality.

Results

A total of 155 497 048 ED attendances were included, of which 125 809 960 (80.9%) had a low HFRS (<5), 27 205 257 (17.5%) had an intermediate HFRS (5–15), and 2 481 831 (1.6%) had a high HFRS (>15). The most common cause of ED attendance in the high-HFRS group was infectious diseases (43.0%), followed by cardiovascular diseases (CVD) (24.0%) and respiratory diseases (10.2%). For the low-HFRS group, musculoskeletal disease was the most common cause (21.2%), followed by respiratory diseases (20.6%) and gastrointestinal diseases (18.5%). On adjusted analysis, high-HFRS attendances had increased overall mortality (combined ED and in-hospital) across most attendance causes, compared with their low-risk counterparts (P < 0.001). High-HFRS attendances with infectious diseases, CVD, and respiratory diseases had an increased risk of overall mortality, compared with their low-risk counterparts (aOR 23.88, 95% CI 23.42–24.34 for the infectious disease cohort; aOR 2.58, 95% CI 2.55–2.61 for the CVD cohort; and aOR 36.90, 95% CI 36.18–37.62 for the respiratory disease cohort).

Conclusions

Frailty is present in a significant proportion of ED attendances, with the cause varying by frailty status. Frailty is associated with decreased ED and increased overall mortality across most attendance causes. Geriatr Gerontol Int 2025; 25: 1350–1358.

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查看原文本刊更多论文

急诊就诊按病因和虚弱状态分层：一项全国回顾性队列研究。

目的：本研究的目的是确定急诊科（ED）就诊的原因和临床结果是否因虚弱状态而异。方法：使用全国ED样本，采用医院衰弱风险评分（HFRS）对就诊原因进行分层。采用Logistic回归确定ED和总死亡率的校正优势比（aORs）和95%置信区间（95% ci）。结果：共纳入急诊就诊人数155 497 048人，其中低HFRS患者125 809 960人，占80.9%（15人）。在高hfrs组中，最常见的ED就诊原因是传染病（43.0%），其次是心血管疾病（24.0%）和呼吸系统疾病（10.2%）。在低hfrs组中，肌肉骨骼疾病是最常见的原因（21.2%），其次是呼吸系统疾病（20.6%）和胃肠道疾病（18.5%）。在调整分析中，与低风险的患者相比，高hfrs患者在大多数就诊原因中都增加了总体死亡率（合并急诊科和住院）(P结论：虚弱在急诊科就诊中占很大比例，其原因因虚弱状态而异。在大多数出勤原因中，虚弱与ED降低和总体死亡率增加有关。Geriatr Gerontol 2025；••: ••-••.

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

Geriatrics & Gerontology International 医学-老年医学

CiteScore

5.50

自引率

6.10%

发文量

189

审稿时长

4-8 weeks

期刊介绍： Geriatrics & Gerontology International is the official Journal of the Japan Geriatrics Society, reflecting the growing importance of the subject area in developed economies and their particular significance to a country like Japan with a large aging population. Geriatrics & Gerontology International is now an international publication with contributions from around the world and published four times per year.