Citation

Earl-Royal EC, Kaufman EJ, Hanlon AL, Holena DN, Rising KL, Kit Delgado M. Am. J. Emerg. Med. 2017; 35(9): 1252-1257.

Affiliation

Leonard Davis Institute of Health Economics, University of Pennsylvania, United States; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States; The Penn Injury Science Center at the University of Pennsylvania, Philadelphia, PA, United States; Department of Emergency Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, United States.

Copyright

(Copyright © 2017, Elsevier Publishing)

DOI

10.1016/j.ajem.2017.03.051

PMID

28410919

Abstract

INTRODUCTION: Emergency Department (ED) visits for injury often precede hospital admissions in older adults, but risk factors for these admissions are poorly characterized. We sought to determine the incidence and risk factors for hospitalization shortly following discharge home from an ED visit for traumatic injury in older adults. We hypothesized higher risk for admission in those with increased age, discharged home after falls, with increased comorbidity burden, and who live in poor neighborhoods.

METHODS: We identified all community-dwelling patients ≥65years old treated and released for traumatic injury at non-federal EDs in Florida using the 2011 State Inpatient Database and State ED Database of the Agency for Healthcare Research and Quality. Outcome measures were hospitalization within 9 and 30days of discharge from the ED. Multivariable logistic regression was used to establish independent risk factors for hospital admission.

RESULTS: Of 163,851 index ED injury visits, 6298 (3.8%) resulted in inpatient admissions within 9days and 12,938 (7.9%) within 30days. Factors associated with increased odds of admission within 9days included: each additional comorbidity, ≥moderate injury to abdomen or pelvis/extremities, and median neighborhood income<$39,000. Additional factors associated with increased odds of admission within 30days included: lack of private insurance supplement and median neighborhood income<$48,000.

CONCLUSION: Among older adults treated and discharged from the ED for an injury, those who have high comorbidity burdens, have abdominal or orthopedic injuries, and live in poor neighborhoods are at increased risk of hospitalization within 9 or 30days of ED discharge.

Copyright © 2016. Published by Elsevier Inc.

Language: en