Unplanned early return to the emergency department by older patients: the Safe Elderly Emergency Department Discharge (SEED) project

Age and Ageing
Judy LowthianPeter Cameron

Abstract

an emergency department (ED) visit is a sentinel event for an older person, with increased likelihood of adverse outcomes post-discharge including early re-presentation. to determine factors associated with early re-presentation. prospective cohort study conducted in the ED of a large acute Melbourne tertiary hospital. Community-dwelling patients ≥65 years were interviewed including comprehensive assessment of cognitive and functional status, and mood. Logistic regression was used to identify risk factors for return within 30 days. nine hundred and fifty-nine patients, median age 77 years, were recruited. One hundred and forty patients (14.6%) re-presented within 30 days, including 22 patients (2.3%) on ≥2 occasions and 75 patients (7.8%) within 7 days. Risk factors for re-presentation included depressive symptoms, cognitive impairment, co-morbidity, triaged as less urgent (ATS 4) and attendance in the previous 12 months, with a decline in risk after 85 years of age. Logistic regression identified chronic obstructive pulmonary disease (OR 1.78, 95% CI 1.02-3.11), moderate cognitive impairment (OR 2.07, 95% CI 1.09-3.90), previous ED visit (OR 2.11, 95% CI 1.43-3.12) and ATS 4 (OR 2.34, 95% CI 1.10-4.99) as independent risk fact...Continue Reading

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Citations

Jun 29, 2017·The American Journal of Emergency Medicine·Sarah JorgensenAnnie Wong-Beringer
Mar 1, 2018·Journal of the American Geriatrics Society·Jelle de GelderSimon P Mooijaart
May 8, 2018·Australasian Journal on Ageing·Judy A LowthianEdward Strivens
Aug 10, 2017·The Journal of International Medical Research·Ravi LallaPaula Robertson
Apr 27, 2019·Journal of Gerontological Nursing·Mu-Hsing HoMegan F Liu
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
Mar 19, 2019·Emergency Medicine Australasia : EMA·Lauren T SoutherlandGlenn Arendts
Nov 19, 2019·The Western Journal of Emergency Medicine·Sophia Sheikh
Jun 27, 2021·Journal of the American Geriatrics Society·Merel van Loon-van GaalenRoos C van der Mast
Oct 19, 2020·The American Journal of Emergency Medicine·Bertram K WoitokGregor Lindner
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
Aug 23, 2021·The American Journal of Emergency Medicine·Joo Yeon MyoungYoon Hee Choi
Aug 31, 2021·Journal of Orthopaedics·Tom J CrijnsAmirreza Fatehi

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