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.