• Elena Fuentes, Javier Jacob, Del CastilloJuan GonzálezJGServicio de Urgencias, Hospital Clínico San Carlos, IDISSC, Universidad Complutense, Madrid, Spain., Francisco Javier Montero-Pérez, Aitor Alquezar-Arbé, Eric Jorge García-Lamberechts, Sira Aguiló, Cesáreo Fernández-Alonso, Guillermo Burillo-Putze, Pascual Piñera, Lluís Llauger, Verónica Vázquez-Rey, Elena Carrasco-Fernández, Ricardo Juárez, María José Blanco-Hoffman, Eva de Las Nieves Rodríguez, Rafaela Rios-Gallardo, María Amparo Berenguer-Diez, Sandra Guiu, Nieves López-Laguna, Violeta Delgado-Sardina, Francisco Javier Diego-Robledo, Patxi Ezponda, Andrea Martínez-Lorenzo, Juan Vicente Ortega-Liarte, Inmaculada García-Rupérez, Setefilla Borne-Jerez, Adriana Gil-Rodrigo, Pere Llorens, Òscar Miró, and EDEN Research Group.
• Servicio de Urgencias, Hospital Universitari de Bellvitge, Universitat de Barcelona, IDIBELL, C/ Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain.
• Intern Emerg Med. 2024 Jun 19.

AbstractThe elderly population frequently consults the emergency department (ED). This population could have greater use of EDs and hospital health resources. The EDEN cohort of patients aged 65 years or older visiting the ED allowed this association to be investigated. To analyse the association between healthcare resource use and the characteristics of patients over 65 years of age who consult hospital EDs. We performed an analysis of the EDEN cohort, a retrospective, analytical, and multipurpose registry that includes patients over 65 years of age who consulted in 52 Spanish EDs. The impact of age, sex, and characteristics of ageing on the following outcomes was studied: need for hospital admission (primary outcome) and need for observation, stay in the ED > 12 h, prolonged hospital stay > 7 days, need for intensive care unit (ICU) and return to the ED at 30 days related to the index visit (secondary outcomes). The association was analysed by calculating the adjusted odds ratios (aOR) and their 95% confidence intervals (CI), using a logistic regression model. A total of 25,557 patients with a mean age of 78.3 years were analysed, 45% were males. Of note was the presence of comorbidity, a Charlson index ≥ 3 (33%), and polypharmacy (66%). Observation in the ED was required by 26%, 25.4% were admitted to the hospital, and 0.9% were admitted to the ICU. The ED stay was > 12 h in 12.5% and hospital stay > 7 days in 13.5% of cases. There was a progressive increase in healthcare resource use based on age, with an aOR for the need for observation of 2.189 (95% CI 2.038-2.352), ED stay > 12 h 2.136 (95% CI 1.942-2.349) and hospital admission 2.579 (95% CI 2.399-2.772) in the group ≥ 85 years old. Most of the characteristics inherent to ageing (cognitive impairment, falls in the previous 6 months, polypharmacy, functional dependence, and comorbidity) were associated with significant increases in the use of healthcare resources, except for ICU admission, which was less in all the variables studied. Age and the characteristics inherent to ageing are associated with greater use of structural healthcare resources.© 2024. The Author(s), under exclusive licence to Società Italiana di Medicina Interna (SIMI).

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