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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



√Ārea de Urgencias, Hospital Cl√≠nic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain. Servicio de Urgencias, Hospital Universitari de Bellvitge, l‚ÄôHospitalet de Llobregat, Barcelona, Spain. Servicio de Urgencias, Hospital Cl√≠nico San Carlos, IDISSC, Universidad Complutense, Madrid, Spain. Servicio de Urgencias, Hospital Reina Sof√≠a, Murcia, Spain. Servicio de Urgencias, 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. Servicio de Urgencias, Hospital Universitario de Canarias, Tenerife, Spain. Servicio de Urgencias, Hospital Reina Sof√≠a, C√≥rdoba, Spain. Servicio de Urgencias, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. Servicio de Urgencias, Hospital Francesc de Borja, Gandia, Valencia, Spain. Servicio de Urgencias, Hospital General Universitario de Elche, Alicante, Spain. Servicio de Urgencias, Hospital Universitario y Polit√©cnico La Fe, Valencia, Spain. Servicio de Urgencias, Hospital del Mar, Barcelona, Spain. Servicio de Urgencias, Hospital Doctor Josep Trueta, Girona, Spain. Servicio de Urgencias, Hospital Sant Pau i Santa Tecla, Tarragona, Spain. Servicio de Urgencias, Hospital Universitario Gregorio Mara√Ī√≥n, Madrid, Spain. Servicio de Urgencias, Hospital Universitario Severo Ochoa, Legan√©s, Madrid, Spain. Servicio de Urgencias, Hospital Universitario Infanta Cristina, Parla, Madrid, Spain. Servicio de Urgencias, Hospital Universitario del Henares, Coslada, Spain. Servicio de Urgencias, Hospital Universitario de Burgos, Burgos, Spain. Servicio de Urgencias, Complejo Asistencial de Soria, Soria, Spain. Servicio de Urgencias, Hospital Regional Universitario de M√°laga, M√°laga, Spain. Servicio de Urgencias, Hospital Valle de los Pedroches, Pozoblanco, C√≥rdoba, Spain. Servicio de Urgencias, Hospital do Saln√©s, Villagarc√≠a de Aurosa, Pontevedra, Spain. Servicio de Urgencias, Hospital Nuestra Se√Īora del Prado, Talavera de la Reina, Toledo, Spain. Servicio de Urgencias, Hospital Morales Meseguer, Murcia, Spain. Servicio de Urgencias, Hospital Lorenzo Guirao, Cieza, Murcia, Spain. Servicio de Urgencias, 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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