Predictors and Outcomes of Revisits in Older Adults Discharged from the Emergency Department

Journal of the American Geriatrics Society
Jelle de GelderSimon P Mooijaart

Abstract

To study predictors of emergency department (ED) revisits and the association between ED revisits and 90-day functional decline or mortality. Multicenter cohort study. One academic and two regional Dutch hospitals. Older adults discharged from the ED (N=1,093). At baseline, data on demographic characteristics, illness severity, and geriatric parameters (cognition, functional capacity) were collected. All participants were prospectively followed for an unplanned revisit within 30 days and for functional decline and mortality 90 days after the initial visit. The median age was 79 (interquartile range 74-84), and 114 participants (10.4%) had an ED revisit within 30 days of discharge. Age (hazard ratio (HR)=0.96, 95% confidence interval (CI)=0.92-0.99), male sex (HR=1.61, 95% CI=1.05-2.45), polypharmacy (HR=2.06, 95% CI=1.34-3.16), and cognitive impairment (HR=1.71, 95% CI=1.02-2.88) were independent predictors of a 30-day ED revisit. The area under the receiver operating characteristic curve to predict an ED revisit was 0.65 (95% CI=0.60-0.70). In a propensity score-matched analysis, individuals with an ED revisit were at higher risk (odds ratio=1.99 95% CI=1.06-3.71) of functional decline or mortality. Age, male sex, polypharmacy...Continue Reading

References

Mar 27, 1999·Annals of Emergency Medicine·I G Stiell, G A Wells
Mar 24, 2000·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·J McCuskerE Belzile
Jan 7, 2003·Annals of Emergency Medicine·Lorraine C MionCharles Emerman
Sep 21, 1963·JAMA : the Journal of the American Medical Association·S KATZM W JAFFE
Dec 4, 2004·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Alex GuttmanStephen Rosenthal
Apr 20, 2006·Quality Management in Health Care·Laurie Landrum, Sally Weinrich
Aug 12, 2008·Journal of the American Geriatrics Society·S Nicole HastingsHeather E Whitson
Apr 8, 2010·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Michael A LaMantiaJohn S Kizer
Jan 4, 2012·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Megan McHughRahul K Khare
Dec 20, 2012·Emergency Medicine Journal : EMJ·Jay BanerjeeMatthew W Cooke
Oct 30, 2013·Emergency Medicine Journal : EMJ·Chetan R Trivedy, Matthew W Cooke
Apr 16, 2014·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Andrew P CostaLeonard C Gray
Apr 22, 2014·Annals of Emergency Medicine·UNKNOWN American College of Emergency PhysiciansUNKNOWN Geriatric Emergency Department Guidelines Task Force
Sep 7, 2014·Annals of Emergency Medicine·Kristin L RisingJudy A Shea
Jan 8, 2015·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Christopher R CarpenterTeresita M Hogan
Aug 12, 2015·Advances in Anatomic Pathology·Karel G M MoonsUNKNOWN Transparent Reporting of a Multivariate Prediction Model for Individual Prognosis or Development Initiative
Apr 20, 2017·Journal of the American Geriatrics Society·Belinda SpotoCarmine Zoccali

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Citations

Sep 18, 2018·Journal of the American Geriatrics Society·Clark DuMontier, Dae Kim
Jan 10, 2019·Journal of the American Geriatrics Society·Gwen Costa JacobsohnManish N Shah
May 14, 2020·Journal of the American Geriatrics Society·Christopher R Carpenter, Simon P Mooijaart
Sep 3, 2020·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Sophia SheikhPhyllis Hendry
Sep 24, 2020·BMC Geriatrics·Babiche E J M DriesenPrabath W B Nanayakkara
Nov 19, 2019·The Western Journal of Emergency Medicine·Sophia Sheikh
May 28, 2021·European Journal of Clinical Nutrition·Paula Luiza Menezes CruzRenata Reis de Lima E Silva
Jun 27, 2021·Journal of the American Geriatrics Society·Merel van Loon-van GaalenRoos C van der Mast
Oct 20, 2020·The American Journal of Emergency Medicine·Lucas Oliveira J E SilvaFernanda Bellolio
Aug 1, 2021·Archives of Gerontology and Geriatrics·Keon KimDong Hoon Lee
Jul 27, 2021·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Gwen C JacobsohnManish N Shah
Aug 23, 2021·The American Journal of Emergency Medicine·Joo Yeon MyoungYoon Hee Choi

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