• Sylvie Bonin-Guillaume, Anne-Claire Durand, Fadila Yahi, Marielle Curiel-Berruyer, Oceana Lacroix, Elodie Cretel, Marc Alazia, Roland Sambuc, and Stephanie Gentile.
• Service de Médecine Interne Gériatrie, Hôpitaux Sud, Assistance Publique Hôpitaux de Marseille, Marseille, France.
• Aging Clin Exp Res. 2015 Dec 1; 27 (6): 883-91.

Background And AimsFor older adults, an Emergency Department (ED) visit represents a period of vulnerability that extends beyond the visit itself. This study aimed to determine the impact of the role of caregiver, and geriatric conditions of patients on early unplanned rehospitalization (EUR) within 3 months after an ED visit.MethodsThis prospective longitudinal experimental study included consecutively 173 patients aged 75 and older admitted in an ED over a 2-week period (18.7% of the total visits). Only older patients having a caregiver were analyzed (78.0%, n = 135). Medical conditions and a comprehensive geriatric assessment were recorded for each patient. All caregivers were interviewed about their tasks and emotional impact using the short Zarit Burden Inventory. Three months after, patients or their caregivers were called about the vital status, and EUR of patients.ResultsAmong the patients included, 64.2% had an EUR and 28.9% of their caregivers reported a high level of burden. EUR was strongly associated with a high caregiver burden (OR 8.7, 95% CI 1.5-49.8). No association was found for patient's medical or geriatric status. Caregivers reported a significantly high burden when patients were malnourished, or were at risk of adverse health outcomes based on the ISAR scale, and when they had greater disabilities in IADLs and ADLs, or cognitive impairments.ConclusionsMany hospital readmissions after an ED visit may be preventable by identifying caregiver's high burden. Reasons that lead to this high burden should be checked at the first visit.

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