title: Common Diagnoses and Outcomes in Elderly Patients Who Present to the Emergency Department with Non-Specific Complaints.
abstract: OBJECTIVE
  Elderly patients often present to the emergency department (ED) with non-specific complaints. Previous studies indicate that such patients are at greater risk for life-threatening illnesses than similarly aged patients with specific complaints. We evaluated the diagnoses and outcomes of elderly patients presenting with non-specific complaints.
  
  
  METHODS
  Two trained data abstractors independently reviewed all records of patients over 70 years old presenting (to two academic EDs) with non-specific complaints, as defined by the Canadian Emergency Department Information System (CEDIS). Outcomes of interest were ED discharge diagnosis, hospital admission, length of stay, and ED revisit within 30 days.
  
  
  RESULTS
  Of the 743 patients screened for the study, 265 were excluded because they had dizziness, vertigo, or a specific complaint recorded in the triage notes. 419 patients (87.7%) presented with weakness and 59 patients (12.3%) presented with general fatigue or unwellness. The most common diagnoses were urinary tract infection (UTI) (11.3%), transient ischemic attack (TIA) (10.0%), and dehydration (5.6%). There were 11 hospital admissions with median length of stay of five days. Eighty-one (16.9%) patients revisited the ED within 30 days of discharge. Regression analysis indicated that arrival to the ED by ambulance was independently associated with hospital admission.
  
  
  CONCLUSIONS
  Our results suggest that elderly patients presenting to the ED with non-specific complaints are not at high risk for life-threatening illnesses. The most common diagnoses are UTI, TIA, and dehydration. Most patients can be discharged safely, although a relatively high proportion revisit the ED within 30 days.
authors.affiliation: *Internal Medicine Residency Program,McMaster University,Hamilton,ON.
authors.forename: Kathleen
authors.initials: K
authors.lastname: Quinn
authors.affiliation: †Family Medicine Residency Program,Dalhousie University,Halifax,NS.
authors.forename: Michael
authors.initials: M
authors.lastname: Herman
authors.affiliation: ‡Division of Emergency Medicine,McMaster University,Hamilton,ON.
authors.forename: Daren
authors.initials: D
authors.lastname: Lin
authors.affiliation: ‡Division of Emergency Medicine,McMaster University,Hamilton,ON.
authors.forename: Wendy
authors.initials: W
authors.lastname: Supapol
authors.affiliation: ‡Division of Emergency Medicine,McMaster University,Hamilton,ON.
authors.forename: Andrew
authors.initials: A
authors.lastname: Worster
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002170:Canada / Q000453:epidemiology; D016638:Critical Illness / Q000453:epidemiology*; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D010343:Patient Admission; D012189:Retrospective Studies; D013997:Time Factors; D014218:Triage / Q000379:methods*
keywords: diagnosis; elderly; weakness