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Pattern of use and presenting complaints of older patients visiting an Emergency Department in Italy

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Abstract

Background and aims

The number of older persons admitted to the Emergency Department (ED) is dramatically increasing due to their complex medical and social problems, which in turn lead to longer clinical evaluation times and increased use of resources compared to younger adults. However, scant data are available for Italian EDs. Similarly, no data are available about the reasons to ED visit and its role in determining the ED utilization pattern. The study aimed at describing the pattern of ED use by older patients and main presenting complaints.

Methods

Cross-sectional descriptive study of 5,826 ED patients in the city of Fano (Italy). Identifiers and triage, clinical and social data were collected. Presenting complaints as recorded by triage nurses have been recoded according to the Canadian Emergency Department Information System list version 1.1. Data were analyzed comparing older patients (more than 65 years-old) with younger adults (less than 65 years-old).

Results

The prevalence of ED visits by older adults was 23.9 %. Their visits were characterized by higher emergency levels, admission rate and length of ED stay. Trauma was the main reason for ED presentation, especially among young adults, but elderly trauma patients were more frequently admitted because of hip fracture. Dyspnea and abdominal pain were the most frequent non-trauma presenting complaints among geriatric patients and represented the main causes for admission.

Conclusions

Older adults use the ED appropriately also in Italy. Trauma with complications (fracture) and various presenting complaints underlying medical problems accounted for more than 50 % of ED visits and hospital admissions.

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Authors and Affiliations

  1. Department of Geriatrics and Emergency Care, Italian National Research Centres on Aging (I.N.R.C.A.), Ancona, Italy

    Fabio Salvi, Valeria Morichi & Antonio Cherubini

  2. Department of Internal Medicine and Geriatrics, Italian National Research Centres on Aging (I.N.R.C.A.) and University Politecnica delle Marche, Ancona, Italy

    Annalisa Mattioli, Elena Giannini & Paolo Dessì-Fulgheri

  3. Emergency Department, Azienda ospedaliera “Ospedali Riuniti Marche Nord”, Fano, Italy

    Diego Vita & Mauro Fallani

  4. Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy

    Antonio Cherubini

  5. Geriatric Emergency Department, I.N.R.C.A., POR Ancona, Via della Montagnola n. 81, 60127, Ancona, Italy

    Fabio Salvi

Authors
  1. Fabio Salvi
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  2. Annalisa Mattioli
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  3. Elena Giannini
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  4. Diego Vita
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  5. Valeria Morichi
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  6. Mauro Fallani
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  7. Paolo Dessì-Fulgheri
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  8. Antonio Cherubini
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Correspondence to Fabio Salvi.

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Salvi, F., Mattioli, A., Giannini, E. et al. Pattern of use and presenting complaints of older patients visiting an Emergency Department in Italy. Aging Clin Exp Res 25, 583–590 (2013). https://doi.org/10.1007/s40520-013-0112-z

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  • DOI: https://doi.org/10.1007/s40520-013-0112-z

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