Résumé
Objectif
L’accroissement du nombre de personnes âgées (PA) s’accompagne d’une augmentation du nombre de consultations aux urgences. Les structures d’urgences (SU) doivent répondre à leurs besoins spécifiques. Les longs temps de passage en SU des PA de plus de 85 ans nous ont conduits à nous interroger sur la possibilité d’accélérer le passage à l’unité d’hospitalisation de courte durée (UHCD) de ces patients, par la création d’un algorithme appelé « fast-track personnes âgées » (FTPA). Le FTPA, consiste en l’admission des PA à l’UHCD dans les deux heures, afin de diminuer leur temps de passage en SU. L’objectif de ce travail est de montrer l’adhésion des médecins à un tel algorithme.
Méthodes
Nous avons mené une étude monocentrique descriptive, durant un mois, sur l’adhésion des équipes à la mise en place de cet algorithme. Pour cela, nous avons comparé le nombre de patients inclus, hospitalisés en moins de 2h, aux mois de mars 2014 et 2015, au nombre de patients éligibles à l’inclusion dans cette algorithme décisionnel. Au-delà de 60 % de patients inclus, l’algorithme sera considéré comme applicable.
Résultats
Au mois de mars 2015, 334 patients de plus de 85 ans ont consulté, 133 patients auraient pu être inclus dans le FTPA et 100 l’ont été, soit 75 %, vs 30 % en mars 2014.
Conclusion
L’utilisation d’un algorithme décisionnel d’aide à l’orientation des PA est applicable.
Abstract
Objective
The increasing number of elderly patients (EP) is related to an increasing number of emergency department (ED) visits. ED must meet their specific needs. The increasing length of stay (LOS) in the ED of persons over 85 years have led us to question the possibility of speeding up their transfer to the ED observation unit, by creating an algorithm called “fast-track for elderly patients”. this fast-track consists of the admission of the EP to the ED observation hospitalization unit within two hours, to reduce their LOS in ED. The objective of this work is to show the adherence of physicians to such an algorithm.
Methods
We conducted a single-center descriptive survey, over a month, on the compliance of medical team to this algorithm. For this, we compared the number of patients included, hospitalized in less than 2 hours, in March 2014 and March 2015, to the number of patients eligible for inclusion in the algorithm. Beyond 60% of patients included, the algorithm will be considered practicable.
Results
In March 2015, 334 EP consulted, 133 could have been included and 100 were included (75%), vs 30 % in March 2014.
Conclusion
Setting up a decision algorithm to help the guidance of EP is workable.
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Arrouy, L., Strohmenger, L., Attal, J. et al. Évaluation de la mise en place d’un fast-track pour les personnes âgées de plus de 85 ans dans un service d’urgence. Ann. Fr. Med. Urgence 6, 233–239 (2016). https://doi.org/10.1007/s13341-016-0658-4
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DOI: https://doi.org/10.1007/s13341-016-0658-4