title: Changes in the clinical features of older patients admitted from the emergency department.
abstract: Demographic changes and healthcare reforms may impact the profile of hospitalized older persons. In this study, we sought to compare the characteristics of two prospective cohorts recruited at a ten-year interval (1999, n=253-2009, n=355). They included older patients (≥75 years) admitted through the emergency department for at least 48 h in acute non-geriatric wards in the same university hospital. The exclusion criteria were patients who were admitted directly to the intensive care unit, who were dependent for all 6 Activities of Daily Living (ADL), who had recently suffered from a major stroke, or whose with a life expectancy of less than 3 months. Median age was higher in 2009 than in 1999 (83 vs. 81; p=0.020), with a higher proportion of those aged 85 years and over (p=0.026). Patients in the 2009 cohort were less likely to live in a nursing home (p=0.018), more dependent for the basic ADL (p<0.001), more independent for the instrumental ADL (p<0.001). They were more likely to have fallen in the previous year (p<0.001). They took more medications (p<0.001). Their length-of-stay was shorter (p<0.001), but they were more likely to be discharged to a rehabilitation center (p<0.001). They underwent more early re-admissions (p=0.020) and similar 3-month functional decline (p=0.614). In conclusion, within a decade, the social, functional and medical characteristics of older patients admitted to hospital have changed significantly. In view of the high consumption of in-patient services by this population, hospitals must adapt to these rapid changes.
authors.affiliation: Institute of Health and Society (IRSS), Université catholique de Louvain, Clos Chapelle-aux-Champs n°30 B1.30.15, 1200 Brussels, Belgium; Department of Geriatric Medicine, Cliniques universitaires Saint Luc, Avenue Hippocrate n°10, 1200 Brussels, Belgium. Electronic address: isabelle.debrauwer@uclouvain.be.
authors.forename: Isabelle
authors.initials: I
authors.lastname: De Brauwer
authors.affiliation: Institute of Health and Society (IRSS), Université catholique de Louvain, Clos Chapelle-aux-Champs n°30 B1.30.15, 1200 Brussels, Belgium.
authors.forename: William
authors.initials: W
authors.lastname: D'Hoore
authors.affiliation: Institute of Health and Society (IRSS), Université catholique de Louvain, Clos Chapelle-aux-Champs n°30 B1.30.15, 1200 Brussels, Belgium; Department of Geriatric Medicine, Centre hospitalier universitaire Mont-Godinne, Avenue G. Therasse n°1, 5530 Yvoir, Belgium.
authors.forename: Christian
authors.initials: C
authors.lastname: Swine
authors.affiliation: Department of Emergency Medicine, Cliniques universitaires Saint Luc, Avenue Hippocrate n°10, 1200 Brussels, Belgium.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Thys
authors.affiliation: Medical Information and Statistics, Cliniques universitaires Saint Luc, Avenue Hippocrate n°10, 1200 Brussels, Belgium.
authors.forename: Claire
authors.initials: C
authors.lastname: Beguin
authors.affiliation: Institute of Health and Society (IRSS), Université catholique de Louvain, Clos Chapelle-aux-Champs n°30 B1.30.15, 1200 Brussels, Belgium; Department of Geriatric Medicine, Cliniques universitaires Saint Luc, Avenue Hippocrate n°10, 1200 Brussels, Belgium.
authors.forename: Pascale
authors.initials: P
authors.lastname: Cornette
mesh_terms: D000203:Activities of Daily Living; D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium; D002908:Chronic Disease; D004636:Emergency Service, Hospital; D005260:Female; D015577:Geriatric Assessment; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D010351:Patient Discharge / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data; D011446:Prospective Studies; D012307:Risk Factors
keywords: Acute hospital; Clinical features changes; Older patients