TY - JOUR
T1 - Elderly emergency patients presenting with non-specific complaints
T2 - Characteristics and outcomes
AU - Wachelder, Joyce J. H.
AU - Stassen, Patricia M.
AU - Hubens, Laura P. A. M.
AU - Brouns, Steffie H. A.
AU - Lambooij, Suze L. E.
AU - Dieleman, Jeanne P.
AU - Haak, Harm R.
PY - 2017/11/30
Y1 - 2017/11/30
N2 - BackgroundNon-specific complaints (NSC) are common at the emergency department, but only a few studies have shown evidence that these complaints are associated with a poor prognosis in elderly emergency patients.ObjectiveTo describe patient characteristics and outcomes in a cohort of elderly emergency patients presenting with NSC. Outcomes were: patient characteristics, hospitalization, 90-day ED-return visits, and 30-day mortality.MethodA retrospective cohort study was conducted amongst elderly patients present to the Internal Medicine Emergency Department (ED) between 01-09-2010 and 31-08-2011. NSC were defined as indefinable complaints that lack a pre-differential diagnosis needed to initiate of a standardized patient evaluation. Cox regression was performed to calculate Hazard Ratios (HR) and corrected for confounders such as comorbidity.ResultsIn total, 1784 patients were enrolled; 244 (13.7%) presented with NSC. Compared to those with SC, comorbidity was higher in the NSC-group (Charlson comorbidity index 3.0 vs. 2.4, p<0.001). The triage level did not differ, but ED-length of stay was longer in the NSC-group (188 vs. 178 minutes, p = 0.004). Hospitalization was more frequent (84.0 vs. 71.1%, p<0.001) and the length of hospital stay (9 vs. 6 days, p<0.001 was longer in the NSC-than in the SC-group. The number of ED-return visits were comparable between both groups (HR 0.8, 95% CI 0.6-1.1). Mortality within 30-days was higher in the NSC-(20.1%) than in the SC-group (11.0%, HR 1.7 95% CI 1.2-2.4).ConclusionElderly patients present with NSC at the ED regularly. These patients are more often hospitalized and have a substantially higher 30-day mortality than patients with SC.
AB - BackgroundNon-specific complaints (NSC) are common at the emergency department, but only a few studies have shown evidence that these complaints are associated with a poor prognosis in elderly emergency patients.ObjectiveTo describe patient characteristics and outcomes in a cohort of elderly emergency patients presenting with NSC. Outcomes were: patient characteristics, hospitalization, 90-day ED-return visits, and 30-day mortality.MethodA retrospective cohort study was conducted amongst elderly patients present to the Internal Medicine Emergency Department (ED) between 01-09-2010 and 31-08-2011. NSC were defined as indefinable complaints that lack a pre-differential diagnosis needed to initiate of a standardized patient evaluation. Cox regression was performed to calculate Hazard Ratios (HR) and corrected for confounders such as comorbidity.ResultsIn total, 1784 patients were enrolled; 244 (13.7%) presented with NSC. Compared to those with SC, comorbidity was higher in the NSC-group (Charlson comorbidity index 3.0 vs. 2.4, p<0.001). The triage level did not differ, but ED-length of stay was longer in the NSC-group (188 vs. 178 minutes, p = 0.004). Hospitalization was more frequent (84.0 vs. 71.1%, p<0.001) and the length of hospital stay (9 vs. 6 days, p<0.001 was longer in the NSC-than in the SC-group. The number of ED-return visits were comparable between both groups (HR 0.8, 95% CI 0.6-1.1). Mortality within 30-days was higher in the NSC-(20.1%) than in the SC-group (11.0%, HR 1.7 95% CI 1.2-2.4).ConclusionElderly patients present with NSC at the ED regularly. These patients are more often hospitalized and have a substantially higher 30-day mortality than patients with SC.
KW - TRIAGE
KW - ADULTS
KW - RISK
U2 - 10.1371/journal.pone.0188954
DO - 10.1371/journal.pone.0188954
M3 - Article
C2 - 29190706
SN - 1932-6203
VL - 12
JO - PLOS ONE
JF - PLOS ONE
IS - 11
M1 - e0188954
ER -