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Disability is associated with emergency room visits in the elderly: a population-based study

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Abstract

Background

Emergency room (ER) visits and hospitalizations of elderly subjects with chronic comorbidities, often disabled, are increasing.

Aims

The aim of the present study was to assess whether among older subjects functional disability is associated with increased ER visits and hospitalization rates.

Methods

We assessed the association of functional ability with 1-year ER visits and hospitalization rates in all 342 subjects aged 75+ living in Tuscania (Italy) in 2004. Functional ability was estimated using the Katz’ activities of daily living (ADLs), and the Lawton and Brody scale for the instrumental activities of daily living (IADLs). Functional disability was defined as the dependence for two or more ADLs or IADLs.

Results

According to Cox regression, disability in ADLs was associated with increased risk of ER visits (RR 2.12; 95 % CI 1.11–4.08; P = .023) but not of hospital admission (RR 1.50; 95 % CI .80–2.80; P = .208). Also, in Poisson regression, ADLs disability predicted the number of ER visits (IRR 2.56; 95 % CI 1.48–4.40; P = .001).

Discussion

Disability is associated with increased risk of ER visits, but not of subsequent hospitalization in community-dwelling elderly, independent of clinical conditions. Dedicated studies are needed to evaluate the impact of social interventions for disabled elderly on ER access rates.

Conclusions

Emergency Departments should implement innovative triage procedures to identify older patients with disability who gain access to ER, to recognize and classify any unmet social needs.

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Acknowledgments

This research was partially supported as a “targeted project” (SS9.4.2) by the Italian Ministry of Health.

Conflict of interest

The authors declare that they are no conflict of interest in this study.

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Authors and Affiliations

  1. Department of Gerontology, Campus Bio-Medico University, Via Álvaro del Portillo, 200, 00128, Rome, Italy

    Alice Laudisio

  2. Department of Gerontology and Geriatrics, Catholic University of Medicine, Rome, Italy

    Emanuele Marzetti & Roberto Bernabei

  3. Emergency Department, Catholic University of Medicine, Rome, Italy

    Francesco Franceschi & Giuseppe Zuccalà

Authors
  1. Alice Laudisio
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  2. Emanuele Marzetti
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  3. Francesco Franceschi
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  4. Roberto Bernabei
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  5. Giuseppe Zuccalà
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Corresponding author

Correspondence to Alice Laudisio.

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Laudisio, A., Marzetti, E., Franceschi, F. et al. Disability is associated with emergency room visits in the elderly: a population-based study. Aging Clin Exp Res 27, 663–671 (2015). https://doi.org/10.1007/s40520-015-0324-5

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  • DOI: https://doi.org/10.1007/s40520-015-0324-5

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