Methods: Upon the IRB approval, we reviewed and analyzed 2,496 EDs visits aged 65 and over during the winter season in 2016. Data were collected via electronic medical records between May 1 and July 30, 2017 from two hospitals located in an urban and rural complex city. Chi square test and logistic regression were applied using SPSS 22.0.
Results: Among the participants, women comprised 53.5% and 17.6% of visits were done by aged 85 and older. Those who lived with their family members comprised 78.6% while 10% lived alone and 11% were transferred from long-term care(LTC) facilities. EDs visits by personal vehicles were 66.1% and 33.9% used ambulance. Status of emergency of the EDs visits were rated by Korean Triage and Acuity System and 68.6% were emergent conditions. About 20.9% received any kinds of public assistantships. Commonly reported chief complaints of the EDs visits were hypoalbuminemia (21.2%), chest pain (18.6%), dyspnea (14.0%) and abdominal pain (8.7%). Among them, chest pain (OR=3.605, 95% CI: 2.258-5.755), dizziness (OR=22.010, 95% CI: 10.755-45.042), dyspnea (OR=5.324, 95% CI: 3.694-7.674) and hypoalbuminemia (OR=1.408, 95% CI: 1.108-1.790) were clinical risk factors for being-emergent condition among older participants in EDs. Although there were no statistically significant differences among places before admission, there were a tendency that older adults transferred from LTC facilities represented a high risk of being emergent condition.
Conclusion: More than two-third older adults’ EDs visits were emergent status. In order to reduce unexpected EDs visits by older adults, the reasons for not controlling chief complaints needed to be identified. As older adults transferred from LTC facilities increase, environments of EDs needed to equip them for providing proper emergent care for older adults.
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