title: Emergency department (ED) utilization and outcome of oldest old men presenting with geriatric syndromes in a veterans care home in Taiwan.
abstract: The first presentation of elderly people in the emergency department (ED) is commonly nonspecific and atypical, often in the form of geriatric syndromes, i.e. falls, immobility, incontinence, or deteriorating mental function. The purpose of this study was to evaluate the management and outcomes of institutionalized elderly people who initially presented with geriatric syndrome (GS) in the ED. A retrospective chart review of Banciao Veterans Care Home residents who visited the ED of a tertiary medical center was done. Demographic data including age, sex, modes of arrival, category of triage, time of visit, main presenting symptoms, principal diagnosis, medical expenditures, and clinical outcomes were recorded. From January to December, 2006, 629 ED visits (mean age, 82.1+/-5.3 years, all male) were retrieved. The overall prevalence of GS was 23.8%. When GS subjects were admitted, they were more likely to be transferred to step-down community hospitals for post-acute care (OR = 2.63; 95% CI: 1.36-5.08, p = 0.004). GS was common in institutionalized elderly people calling for ED services, and GS subjects were more likely to be transferred to step-down community hospitals after hospitalization. Comprehensive geriatric assessments may be of value for institutionalized elderly patients visiting the ED.
authors.affiliation: Department of Family Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 81346, Taiwan.
authors.forename: Ming-Yueh
authors.initials: MY
authors.lastname: Chou
authors.forename: Shang-Lin
authors.initials: SL
authors.lastname: Chou
authors.forename: Yuann-Meei
authors.initials: YM
authors.lastname: Tzeng
authors.forename: Liang-Kung
authors.initials: LK
authors.lastname: Chen
authors.forename: David Hung-Tsang
authors.initials: DH
authors.lastname: Yen
authors.forename: Shinn-Jang
authors.initials: SJ
authors.lastname: Hwang
authors.forename: Chun-I
authors.initials: CI
authors.lastname: Huang
authors.forename: Ming-Shium
authors.initials: MS
authors.lastname: Tu
authors.forename: Chen-Hsen
authors.initials: CH
authors.lastname: Lee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004632:Emergency Medical Services / Q000191:economics / Q000706:statistics & numerical data*; D005853:Geriatrics / Q000706:statistics & numerical data*; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006707:Homes for the Aged; D006764:Hospitals, Community / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000191:economics / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013577:Syndrome; D013624:Taiwan; D016896:Treatment Outcome; D014218:Triage; D014728:Veterans