Citation

Dubucs X, de Souto Barreto P, Laffon de Mazieres C, Lauque D, Azéma O, Charpentier S, Rolland Y. J. Am. Med. Dir. Assoc. 2019; ePub(ePub): ePub.

Affiliation

Gérontopole de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France; Unité Mixe de Recherche, UMR 1027, Université Toulouse III, Toulouse, France.

Copyright

(Copyright © 2019, Lippincott Williams and Wilkins)

DOI

10.1016/j.jamda.2019.07.013

PMID

31477555

Abstract

OBJECTIVES: There has been an increase in the number of visits by older individuals to emergency departments (EDs). The primary cause of this is trauma. The objective of this study was to evaluate the temporal changes in the use of EDs by older individuals for traumatic injuries, characterize their trauma, and specify the mode of transport to the ED according to their place of residence (community-dwelling or nursing home resident).

DESIGN: A monocentric, retrospective study of patients over 65 years of age, admitted to University Center Hospital ED for trauma between 2013 and 2017. PARTICIPANTS: In total, 20,741 patients were included.

RESULTS: The mean age was 81.8 years (standard deviation 9.1 years); 11,879 (57.3%) patients were community-living with family, 5077 (24.5%) were nursing home (NH) residents, and 3785 (18.22%) patients were community-dwelling living alone. Overall, 33.3% of the NH residents were transferred during the weekend compared with 28.04% of the community-dwelling individuals (P < .001). Ten percent (1577 patients) of the community-dwelling individuals compared with 21.8% (1109 patients) of the transfers of NH residents to ED occurred late at night (P < .001). The primary reason for use of the ED was head trauma (32.0%), followed by cutaneo-mucous wounds (28.7 %) and limb fractures (25.9%). In most cases, NH residents were transferred by ambulance (5000 residents; 98.4%), compared with community-dwelling individuals (11,118; 70.1%; P < .001). Overall, 7459 (36.0 %) patients were hospitalized.

CONCLUSION AND IMPLICATIONS: In comparison with community-dwelling individuals, ED transfers of NH residents in the context of trauma-related emergency were higher during after-hour periods, lengthes of stay at the ED were longer, and residents were admitted less to the in hospital.

Copyright © 2019 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Language: en

Keywords

Emergency department; community dwelling older adults; nursing home; traumatic injury