Risk of admission within 4 weeks of discharge of elderly patients from the emergency department--the DEED study. Discharge of elderly from emergency department.
OBJECTIVE
to 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).


METHODS
Prospective evaluation of discharged elderly patients from the emergency department who were followed up after 4 weeks.


METHODS
emergency department of a teaching hospital for 1 year.


METHODS
patients aged 75 and over discharged to their home or hostel.


METHODS
demographic data, indices of function and cognitive status and admission to hospital within 4 weeks.


RESULTS
468 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.


CONCLUSIONS
older 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.
Post Acute Care Services, Prince of Wales Hospital, Randwick, NSW, Australia. G.Caplan@unsw.edu.au
G A
GA
Caplan
A
A
Brown
W D
WD
Croker
J
J
Doolan
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006299:Health Services for the Aged / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D010351:Patient Discharge / Q000706:statistics & numerical data* / Q000639:trends; D010359:Patient Readmission / Q000706:statistics & numerical data* / Q000639:trends; D011446:Prospective Studies; D012307:Risk Factors; D012934:Social Isolation; D013997:Time Factors