Factors associated with hospital admission after an emergency department treat and release visit for older adults with injuries. Am J Emerg Med 2017 Sep;35(9):1252-1257
Date
04/16/2017Pubmed ID
28410919Pubmed Central ID
PMC5854494DOI
10.1016/j.ajem.2017.03.051Scopus ID
2-s2.0-85017386184 (requires institutional sign-in at Scopus site) 4 CitationsAbstract
INTRODUCTION: Emergency Department (ED) visits for injury often precede hospital admissions in older adults, but risk factors for these admissions are poorly characterized. We sought to determine the incidence and risk factors for hospitalization shortly following discharge home from an ED visit for traumatic injury in older adults. We hypothesized higher risk for admission in those with increased age, discharged home after falls, with increased comorbidity burden, and who live in poor neighborhoods.
METHODS: We identified all community-dwelling patients ≥65years old treated and released for traumatic injury at non-federal EDs in Florida using the 2011 State Inpatient Database and State ED Database of the Agency for Healthcare Research and Quality. Outcome measures were hospitalization within 9 and 30days of discharge from the ED. Multivariable logistic regression was used to establish independent risk factors for hospital admission.
RESULTS: Of 163,851 index ED injury visits, 6298 (3.8%) resulted in inpatient admissions within 9days and 12,938 (7.9%) within 30days. Factors associated with increased odds of admission within 9days included: each additional comorbidity, ≥moderate injury to abdomen or pelvis/extremities, and median neighborhood income<$39,000. Additional factors associated with increased odds of admission within 30days included: lack of private insurance supplement and median neighborhood income<$48,000.
CONCLUSION: Among older adults treated and discharged from the ED for an injury, those who have high comorbidity burdens, have abdominal or orthopedic injuries, and live in poor neighborhoods are at increased risk of hospitalization within 9 or 30days of ED discharge.
Author List
Earl-Royal EC, Kaufman EJ, Hanlon AL, Holena DN, Rising KL, Kit Delgado MAuthor
Daniel N. Holena MD Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AgedAged, 80 and over
Comorbidity
Databases, Factual
Emergency Service, Hospital
Female
Florida
Humans
Incidence
Income
Logistic Models
Male
Multivariate Analysis
Patient Admission
Patient Discharge
Retrospective Studies
Risk Factors
Wounds and Injuries
