title: A controlled evaluation of comprehensive geriatric assessment in the emergency department: the 'Emergency Frailty Unit'.
abstract: BACKGROUND
  the ageing demographic means that increasing numbers of older people will be attending emergency departments (EDs). Little previous research has focused on the needs of older people in ED and there have been no evaluations of comprehensive geriatric assessment (CGA) embedded within the ED setting.
  
  
  METHODS
  a pre-post cohort study of the impact of embedding CGA within a large ED in the East Midlands, UK. The primary outcome was admission avoidance from the ED, with readmissions, length of stay and bed-day use as secondary outcomes.
  
  
  RESULTS
  attendances to ED increased in older people over the study period, whereas the ED conversion rate fell from 69.6 to 61.2% in people aged 85+, and readmission rates in this group fell from 26.0% at 90 days to 19.9%. In-patient bed-day use increased slightly, as did the mean length of stay.
  
  
  CONCLUSIONS
  it is possible to embed CGA within EDs, which is associated with improvements in operational outcomes.
authors.affiliation: University of Leicester School of Medicine, Room 540, Clinical Sciences Building Leicester Royal Infirmary, Leicester LE2 7LX, UK.
authors.forename: Simon Paul
authors.initials: SP
authors.lastname: Conroy
authors.forename: Kharwar
authors.initials: K
authors.lastname: Ansari
authors.forename: Mark
authors.initials: M
authors.lastname: Williams
authors.forename: Emily
authors.initials: E
authors.lastname: Laithwaite
authors.forename: Ben
authors.initials: B
authors.lastname: Teasdale
authors.forename: Jeremey
authors.initials: J
authors.lastname: Dawson
authors.forename: Suzanne
authors.initials: S
authors.lastname: Mason
authors.forename: Jay
authors.initials: J
authors.lastname: Banerjee
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D015331:Cohort Studies; D004636:Emergency Service, Hospital; D004739:England; D016330:Frail Elderly; D015577:Geriatric Assessment; D006302:Health Services Research; D006757:Hospital Units; D006801:Humans; D007902:Length of Stay; D008875:Middle Aged; D010343:Patient Admission; D010359:Patient Readmission; D013997:Time Factors; D055815:Young Adult
keywords: CGA; comprehensive geriatric assessment; emergency medicine; health services research; older people