• Emergencias · Dec 2022

    Multicenter Study

    Factors associated with short-term mortality after emergency department care of residents living in aged care homes: findings from the multicenter Caregency study.

    • F Javier Afonso-Argilés, Mercè Comas Serrano, Marta Blázquez-Andión, Xavier Castells Oliveres, Isabel Cirera Lorenzo, Dolors García Pérez, J María Gómez Roldán, Teresa Pujadas Lafarga, Xavier Ichart Tomás, Mireia Puig-Campmany, RizziMiguel AMAServicio de Urgencias, Hospital de la Santa Creu i Sant Pau, Barcelona, España., Alba Sinfreu Pujol, Isabel Tejero Cano, Ana B Vena Martínez, Héctor Villanueva Sánchez, and Anna Renom-Guiteras.
    • Servicio de Geriatría, Fundació Sanitària Mollet, Barcelona, España. Estudiante de doctorado de la Universitat Autònoma de Barcelona, Barcelona, España.
    • Emergencias. 2022 Dec 1; 34 (6): 437443437-443.

    ObjectivesTo evaluate short-term mortality in people transferred from aged care homes for treatment in a hospital emergency department (ED) and to analyze factors associated with mortality.Material And MethodsMulticenter study of a random sample of retrospective data of patients treated in 5 EDs in Catalonia in 2017. The patients were over the age of 65 years and lived in residential care facilities. In addition to short-term mortality (in the ED or within 30 days of discharge), we analyzed sociodemographic characteristics, prior functional and cognitive status, multimorbidity, triage level on arrival, length of stay in the ED, and hospital admission. Odds ratios (ORs) for factors associated with short-term mortality were calculated by multivariate regression analysis.ResultsA total of 2444 ED admissions were analyzed. The patients' mean (SD) age was 85.9 (7.1) years, and 67.7% .were women. Short-term mortality (in 15.5%) was associated with age >90 years (OR, 1.50; 95% CI, 1.5-1.95 years), a Charlson index >2 (OR, 1.47; 95% CI, 1.14-1.90), and dependency assessed as moderate (OR, 1.50; 95% CI, 1.03- 2.20) or severe (OR, 2.56; 95% CI, 1.84-3.55). Other associated factors were a higher level of urgency on triage, duration of ED stay, and hospital admission.ConclusionAged residents with the characteristics associated with short-term mortality could benefit from interventions for potentially avoiding unnecessary transfers to an ED, and from the implementation of comprehensive geriatric care within the ED. This could be useful to support good quality of care at the end of life.

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