• G A Caplan, A Brown, W D Croker, and J Doolan.
• Post Acute Care Services, Prince of Wales Hospital, Randwick, NSW, Australia. G.Caplan@unsw.edu.au
• Age Ageing. 1998 Nov 1;27(6):697-702.

Objectiveto identify risk factors for admission for patients aged 75 years and older after discharge from the emergency department (DEED: discharge of elderly from emergency department).DesignProspective evaluation of discharged elderly patients from the emergency department who were followed up after 4 weeks.Settingemergency department of a teaching hospital for 1 year.Subjectspatients aged 75 and over discharged to their home or hostel.Main Outcome Measuresdemographic data, indices of function and cognitive status and admission to hospital within 4 weeks.Results468 patients aged 75 and over (mean age 81.7 years; range 75-98) were enrolled; 80 patients (17.1%) were admitted to hospital during the subsequent 4 weeks. Risk factors for admission included dependence in the following activities of daily living (relative risk; 95% confidence interval): bathing (2.41; 1.32-4.41); dressing (2.38; 1.22-4.63); stairs (1.60; 1.09-2.33); finance (1.66; 1.23-2.25); shopping (1.39; 1.12-1.73) and transport (1.61; 1.25-2.06), as well as use of a community nurse (1.88; 1.12-3.17). Logistic regression analysis found two variables to be significant in predicting admission or not: dependence in transport and use of a community nurse.Conclusionsolder patients are at increased risk of readmission within 4 weeks of being sent home from the emergency department. It is possible to identify high-risk patients by a questionnaire. This allows targeting of these patients for more intensive follow-up in an attempt to ameliorate further deteriorations in their health.

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