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Sociodemographic characteristics, functional status, and health resource use of older patients treated in Spanish emergency departments: a description of the EDEN cohort




Mir√≥ O, Jacob J, Garc√≠a-Lamberechts EJ, Pi√Īera Salmer√≥n P, Llorens P, Jim√©nez S, Burillo-Putze G, Montero-P√©rez FJ, Aguil√≥ S, Gil-Rodrigo A, Fern√°ndez Alonso C, Alqu√©zar-Arb√© A, Parra-Esquivel PC, Fortuny Bayarri MJ, Gonz√°lez Tejera M, Gonz√°lez Tejera R, Mill√°n Soria J, Cirera I, Adroher M, Mart√≠n Mojarro E, Gargallo Garc√≠a E, Valle B, D√≠az Salado A, Ruiz Grisp√°n M, L√≥pez D√≠ez MP, Beddar Chaib F, Salido Mota M, Pedraza Garc√≠a J, S√°nchez Sind√≠n G, Ju√°rez Gonz√°lez R, P√©rez Costa RA, Escudero S√°nchez C, Prieto Zapico A, Gonz√°lez Del Castillo J



Emergency Department, Hospital Cl√≠nic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain. Emergency Department, Hospital Universitari de Bellvitge, l‚ÄôHospitalet de Llobregat, Barcelona, Spain. Emergency Department, Hospital Cl√≠nico San Carlos, IDISSC, Universidad Complutense, Madrid, Spain. Emergency Department, Hospital Reina Sof√≠a, Murcia, Spain. Emergency Department, Unidad de Estancia Corta y Hospitalizaci√≥n a Domicilio, Hospital Doctor Balmis, Instituto de Investigaci√≥n Sanitaria y Bi√≥medica de Alicante (ISABIAL), Universidad Miguel Hern√°ndez, Alicante, Spain. Emergency Department, Hospital Universitario de Canarias, Tenerife, Spain. Emergency Department, Hospital Reina Sof√≠a, C√≥rdoba, Spain. Emergency Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. Emergency Department, Hospital Francesc de Borja, Gandia, Valencia, Spain. Emergency Department, Hospital General Universitario de Elche, Alicante, Spain. Emergency Department, Hospital Universitario y Polit√©cnico La Fe, Valencia, Spain. Emergency Department, Hospital del Mar, Barcelona, Spain. Emergency Department, Hospital Doctor Josep Trueta, Girona, Spain. Emergency Department, Hospital Sant Pau i Santa Tecla, Tarragona, Spain. Emergency Department, Hospital Universitario Gregorio Mara√Ī√≥n, Madrid, Spain. Emergency Department, Hospital Universitario Severo Ochoa, Legan√©s, Madrid, Spain. Emergency Department, Hospital Universitario Infanta Cristina, Parla, Madrid, Spain. Emergency Department, Hospital Universitario del Henares, Coslada, Spain. Emergency Department, Hospital Universitario de Burgos, Burgos, Spain. Emergency Department, Complejo Asistencial de Soria, Soria, Spain. Emergency Department, Hospital Regional Universitario de M√°laga, M√°laga, Spain. Emergency Department, Hospital Valle de los Pedroches, Pozoblanco, C√≥rdoba, Spain. Emergency Department, Hospital do Saln√©s, Villagarc√≠a de Aurosa, Pontevedra, Spain. Emergency Department, Hospital Nuestra Se√Īora del Prado, Talavera de la Reina, Toledo, Spain. Emergency Department, Hospital Morales Meseguer, Murcia, Spain. Emergency Department, Hospital Lorenzo Guirao, Cieza, Murcia, Spain. Emergency Department, Hospital do Barbanza, Ribeira, A Coru√Īa, Spain.



Objectives. To describe the sociodemographic characteristics of and the health care resources used to treat patients aged 65 years or older who come to hospital emergency departments (EDs) in Spain, according to age groups.
Methods. We studied the phase-1 data for the EDEN cohort (Emergency Department and Elder Needs). Forty Spanish EDs collected data on all patients aged 65 years or older who were treated on the first 7 days in April 2019. We registered information on 6 sociodemographic and 5 function variables for all patients. For health resource use we
used 6 diagnostic, 13 therapeutic, and 5 physical structural variables, for a total of 24 variables. Differences were analyzed according to age in blocks of 5 years.
Results. A total of 18374 patients with a median age of 78 years were included; 55% were women. Twenty-seven percent arrived by ambulance, 71% had not previously been seen by a physician, and 13% lived alone without assistance. Ten percent had a high level of functional dependence, and 14% had serious comorbidity. Resources used most often were blood analysis (in 60%) and radiology (59%), analgesics (25%), intravenous fluids (21%), antibiotics (14%), oxygen (13%), and bronchodilators (11%). Twenty-six percent were kept under observation in the ED, 26% were admitted to wards, and 2% were admitted to intensive care units (ICUs). The median stay in the ED was 3.5 hours, and the median hospital stay was 7 days. Sociodemographic characteristics changed according to age. Functional dependence worsened with age, and resource requirements increased in general. However, benzodiazepine use was unaffected, while the use of nonsteroidal anti-inflammatory drugs and ICU admission decreased.
Conclusions. The functional dependence of older patients coming to EDs increases with age and is associated with a high level of health care resource use, which also increases with age. Planners should take into consideration the characteristics of the older patients and the proportion of the caseload they represent when arranging physical spaces
and designing processes for a specific ED.


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