Monday, March 7, 2016 | By Zack Budryk
Elderly
emergency department patients with a few key symptoms are at particular
risk for intensive care admission or death in the hospital, according to a new study published in the Annals of Emergency Medicine.
Researchers,
led by Gelareh Gabayan, M.D., of the Department of Medicine at the
University of California at Los Angeles, analyzed ED visit records for
300 elderly patients discharged from any of 13 hospitals in 2009 and
2010. They found four symptoms made patients more likely to die or be
admitted to the intensive care unit or die within a week of the visit:
- Low blood pressure
- Elevated heart rate
- Cognitive impairment
- Changes in disposition between admission and discharge
"Emergency
physicians must exercise extra caution when making the decision to
admit or discharge a geriatric patient," Gabayan said in a statement.
"These patients tend to be more delicate than their younger
counterparts. Even abnormal vital signs, like blood pressure and heart
rate, are associated with potentially catastrophic events for patients
who are discharged from the ER rather than admitted."
The
results, Gabayan added, demonstrate that hospital leaders and patient
family members alike should exercise caution when it comes to
discharging geriatric patients from emergency settings. In early 2014, four
healthcare industry group issued new standardized guidelines for
geriatric emergency care to address the risks such patients present, FierceHealthcare previously reported, including falls, delirium, dementia and medication mismanagement. As the population ages, hospitals have increasingly tailored emergency services to geriatric patients, to the point of opening EDs specifically for the elderly.
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