title: Ambulance transport of the oldest old in Tokyo: a population-based study.
abstract: BACKGROUND
  Few studies have investigated ambulance utilization in people aged 85 years or older, ie, the oldest old.
  
  
  METHODS
  We conducted a 1-year population-based observational study of patients transported by ambulance to emergency departments in Tokyo, Japan, which has a population of about 12 million. Demographic data, symptoms/events associated with ambulance transport, and the proportion of hospital admissions were recorded. Transport rates by age and sex were calculated using data for the background population and ambulance transports, and the 10 most frequent symptoms/events requiring transport were compared between the oldest old and those aged 65 to 84 years.
  
  
  RESULTS
  Of the 642,764 patients who were transported to hospitals by ambulances, 59 570 (9%) were aged ≥ 85 years; 64% were women. The annual ambulance transport rate for this population was 250 per 1000/year and was significantly greater than the rate (90 per 1000/year) for those aged 65 to 84 years. The highest rate was for men aged 85 to 99 years (292 per 1000/year). Among the oldest old, the most frequent reason for ambulance transport was fall (38.5 per 1000/year), and the symptom most likely to result in hospital admission was dyspnea.
  
  
  CONCLUSIONS
  The ambulance transport rate for the oldest old was high, particularly among men aged ≥ 95 years. To reduce the need for ambulance transport among the oldest old, preventive care is needed to reduce falls and acute exacerbations of cardiac and respiratory disorders.
authors.affiliation: Department of Medicine, Mito Kyodo Hospital, Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan. tokuyasu@orange.ocn.ne.jp
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Tokuda
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Abe
authors.forename: Shinichi
authors.initials: S
authors.lastname: Ishimatsu
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Hinohara
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over / Q000706:statistics & numerical data*; D000552:Ambulances / Q000706:statistics & numerical data*; D004417:Dyspnea / Q000628:therapy; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data; D017678:Sex Distribution; D014041:Tokyo
references.citation: Am J Emerg Med. 2000 Mar;18(2):130-4
references.pmid: 10750914
references.citation: Geriatr Gerontol Int. 2009 Sep;9(3):290-7
references.pmid: 19702940
references.citation: Nihon Koshu Eisei Zasshi. 2001 Jan;48(1):56-64
references.pmid: 11235127
references.citation: Nihon Koshu Eisei Zasshi. 2003 Sep;50(9):879-89
references.pmid: 14577274
references.citation: Home Health Care Serv Q. 2007;26(4):79-92
references.pmid: 18032201
references.citation: Age Ageing. 2005 Jan;34(1):24-30
references.pmid: 15496462
references.citation: Qual Saf Health Care. 2006 Dec;15(6):390-2
references.pmid: 17142584
references.citation: J Gerontol. 1987 Nov;42(6):638-42
references.pmid: 3680884
references.citation: Med Care. 1991 May;29(5):408-18
references.pmid: 2020206
references.citation: Acad Emerg Med. 2003 Jan;10(1):52-8
references.pmid: 12511315
references.citation: Am J Emerg Med. 2009 Feb;27(2):153-9
references.pmid: 19371521
references.citation: Eur J Emerg Med. 1999 Jun;6(2):115-8
references.pmid: 10461554
references.citation: J Emerg Med. 2003 Feb;24(2):189-98
references.pmid: 12609651
references.citation: Soc Sci Med. 1998 Apr;46(8):1027-31
references.pmid: 9579754
references.citation: Geriatr Gerontol Int. 2008 Dec;8(4):272-7
references.pmid: 19149839
references.citation: J Accid Emerg Med. 1999 Mar;16(2):108-11
references.pmid: 10191443
references.citation: Geriatr Gerontol Int. 2008 Sep;8(3):139-42
references.pmid: 18821996
references.citation: BMC Geriatr. 2007 Feb 23;7:4
references.pmid: 17316454
references.citation: J Am Geriatr Soc. 2008 Mar;56(3):573-4
references.pmid: 18315676
references.citation: Geriatr Gerontol Int. 2009 Jun;9(2):140-7
references.pmid: 19740357
references.citation: Ann Emerg Med. 1992 Jul;21(7):819-24
references.pmid: 1610039
references.citation: Singapore Med J. 2002 Jan;43(1):33-6
references.pmid: 12008774
references.citation: Adv Ther. 2006 Jan-Feb;23(1):47-53
references.pmid: 16644606
references.citation: Acad Emerg Med. 2006 Aug;13(8):879-85
references.pmid: 16825670