@article{ref1,
title="Increased medical attention needed for frail elderly initially admitted to the emergency department for lack of community support",
journal="Aging (Kurtis)",
year="1999",
author="Elmståhl, S. and Wahlfrid, C.",
volume="11",
number="1",
pages="56-60",
abstract="The demographic changes in society with growing numbers of elderly subjects will inevitably increase admission rates to acute emergency departments (AMU). Early discharge might augment emergency readmissions due to a relapse in medical conditions. Our aim was to study precipitating factors in frail elderly patients who got the diagnosis &quot;lack of community support&quot; after initial medical examination at an AMU, as well as discharge rates and one-year mortality. The study population was 380 cases of 18,015 patients attending the AMU at a city hospital during one year. Inclusion criteria were age above 65 years, and given the diagnosis &quot;lack of community support&quot; by a physician, defined as no other etiological or symptom diagnosis after an initial medical examination, and in some cases 24 to 48-hours observation. All but three medical records were checked. Reduced ability to eat, drink and walk prior to admission were noted among 22 to 58% of cases. Two thirds of the patients needed further medical care as inpatients, and physical medical causes were identified in 85% of the cases (mean number 3 causes); infectious diseases, cardiovascular diseases, dementia and trauma were the most prevalent factors. The median hospital stay was 14 days, and 10% had been discharged from the hospital the week prior to admission. The one-year mortality was 34%. The deceased had more precipitating physical causes, and were more often admitted to medical wards, but fewer had been referred to a senior consultant at the time of admission than survivors, adjusted for age (14% vs 42%, p < 0.05). Multiple medical conditions were noted in the majority of patients admitted to an emergency department with reduced abilities to cope with basic activities of daily life, even though a preliminary examination stated lack of social support as the underlying cause. The need for better medical attention seems important, especially for patients discharged directly home from an emergency department.<p /><p>Language: en</p>",
language="en",
issn="0394-9532",
doi="",
url="http://dx.doi.org/"
}