• Am J Emerg Med · Aug 2021

    Observational Study

    Should age be incorporated into the adult triage algorithm in the emergency department?

    • Alexander D Ginsburg, Oliveira J E SilvaLucasLDepartment of Emergency Medicine, Mayo Clinic, Rochester, MN, USA., Aidan Mullan, Kubwimana Moses Mhayamaguru, Susan Bower, Molly M Jeffery, and Fernanda Bello... more lio. less
    • Department of Emergency Medicine, Mayo Clinic, Rochester, MN, USA.
    • Am J Emerg Med. 2021 Aug 1; 46: 508-514.

    ObjectiveTo compare resource utilization and mortality between older and younger adult patients with similar ED chief complaints and ESI triage levels.MethodsThis was an observational study of consecutive adult patients (age ≥ 40) who presented to an academic ED over a 1-year period with chest pain, abdominal pain, altered mental status, generalized weakness, or headache. Patients were categorized into 40-64, 65-79, and ≥ 80-year old groups. Mortality and utilization outcomes were compared between age groups through logistic regression models or Cox proportional hazards adjusting for ESI level and chief complaint. Odds ratios (OR) and hazard ratios (HR) were calculated with 95% confidence intervals (CI).ResultsA total of 9798 ED visits were included. As compared to younger adults (age 40-64), older adults, independently of ESI level and chief complaint, had higher ED laboratory use (OR 1.46 [CI 1.29, 1.66] for age 65-80; OR 1.33 [CI 1.15, 1.55] for age ≥ 80), ED radiology use (OR 1.40 [CI 1.26, 1.56]; OR 1.48 [CI 1.30, 1.69]), hospital admission (OR 1.56 [CI 1.42, 1.72]; OR 1.97 [CI 1.75, 2.21]), and ICU admission (OR 1.38 [CI 1.15, 1.65]; OR 1.23 [CI 0.99, 1.52]). Despite similar ESI and chief complaint, patients age 65-79 and ≥ 80 had higher 30-day mortality rates (HR 1.87 [CI 1.39 to 2.51] and 2.47 [CI 1.81 to 3.37], respectively).ConclusionsOlder adults with similar chief complaints and ESI levels than younger adults, have significantly higher ED resource use, hospitalization rates, and mortality.Copyright © 2020. Published by Elsevier Inc.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        

    hide…

What will the 'Medical Journal of You' look like?

Start your free 21 day trial now.

We guarantee your privacy. Your email address will not be shared.