Profiles of Older Patients in the Emergency Department: Findings from the interRAI Multinational Emergency Department Study
Gray, Len × Peel, Nancye # Costa, Andrew Burkett, Ellen Dey, Aparajit Jonsson, Palmi Lakhan, Prabha Ljunggren, Gunnar Sjostrand, Fredrik Swoboda, Walter Wellens, Nathalie Hirdes, John #
Annals of Emergency Medicine vol:62 issue:5 pages:467-474
Study objective: We examine functional profiles and presence of geriatric syndromes among older patients
attending 13 emergency departments (EDs) in 7 nations.
Methods: This was a prospective observational study of a convenience sample of patients, aged 75 years and
older, recruited sequentially and mainly during normal working hours. Clinical observations were drawn from the
interRAI Emergency Department Screener, with assessments performed by trained nurses.
Results: A sample of 2,282 patients (range 98 to 549 patients across nations) was recruited. Before becoming unwell,
46% were dependent on others in one or more aspects of personal activities of daily living. This proportion increased to 67% at presentation to the ED. In the ED, 26% exhibited evidence of cognitive impairment, and 49% could not walk without supervision. Recent falls were common (37%). Overall, at least 48% had a geriatric syndrome before becoming unwell,
increasing to 78% at presentation to the ED. This pattern was consistent across nations.
Conclusion: Functional problems and geriatric syndromes affect the majority of older patients attending the ED, which may have important implications for clinical protocols and design of EDs.