Impact of Frailty and Sociodemographic Factors on Hospital Admission From an Emergency Department Observation Unit.
Understanding factors associated with an increased risk of hospital admission from emergency department (ED) observation units (OUs) could be valuable in disposition decisions. To evaluate the impact of frailty and sociodemographic factors (SDFs) on admission risk, patients in an ED OU were surveyed. Survey measures included SDFs, social habits, and frailty measured by the Katz Index of Independence in Activities of Daily Living. Of 306 surveyed, 18% were admitted and 82% were discharged. Demographics were similar between groups. More admitted patients responded positively to the Katz Index (28% vs 13%, P = .007; odds ratio = 2.73; 95% CI = 1.35-5.51). College graduation and current employment favored the discharge group, while admitted patients were more likely to receive Social Security disability insurance. Frailty remained associated with admission on multivariable analysis. Frailty, disability insurance, and lower education are predictors of admission from an OU and could serve as screening criteria in disposition decisions.
1 Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH.
Michael J
MJ
Zdradzinski
1 Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH.|2 Emergency Services Institute at the Cleveland Clinic, Cleveland, OH.
Michael P
MP
Phelan
1 Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH.|2 Emergency Services Institute at the Cleveland Clinic, Cleveland, OH.
Sharon E
SE
Mace
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D015992:Body Mass Index; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D000073496:Frailty / Q000453:epidemiology*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012907:Smoking / Q000453:epidemiology; D012943:Social Security / Q000706:statistics & numerical data; D012944:Social Support; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology
admission; frailty; observation unit; sociodemographic status