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Nursing home residents at the Emergency Department: a 6-year retrospective analysis in a Swiss academic hospital

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Abstract

The increasing number of elderly persons produces an increase in emergency department (ED) visits by these patients, including nursing home (NH) residents. This trend implies a major challenge for the ED. This study sought to investigate ED visits by NH residents in an academic hospital. A retrospective monocentric analysis of all ED visits by NH residents between 2005 and 2010 in a Swiss urban academic hospital. All NH residents aged 65 years and over were included. Socio-demographic data, mode of transfer to ED, triage severity rating, main reason for visit, ED and hospital length of stay, discharge dispositions, readmission at 30 and 90 day were collected. Annual ED visits by NH residents increased by 50 % (from 465 to 698) over the study period, accounting for 1.5 to 1.9 % of all ED visits from 2005 to 2010, respectively. Over the period, yearly rates of ED visits increased steadily from 18.8 to 27.5 per 100 NH residents. Main reasons for ED visits were trauma, respiratory, cardiovascular, digestive, and neurological problems. 52 % were for urgent situations. Less than 2 % of NH residents died during their ED stay and 60 % were admitted to hospital wards. ED use by NH residents disproportionately increased over the period, likely reflecting changes in residents and caregivers’ expectations, NH staff care delivery, as well as possible correction of prior ED underuse. These results highlight the need to improve ED process of care for these patients and to identify interventions to prevent potentially unnecessary ED transfers.

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Acknowledgments

Preliminary results of this study were presented as an oral presentation at the Swiss Congress of Internal Medicine (SCIM) in Basel, Switzerland on May 20th 2015.

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Correspondence to Pierre-Nicolas Carron.

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The authors declare that they have no conflict of interest.

Statement of human and animal rights

The study was approved by the State Authorities and by the Lausanne University Ethics Committee.

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Because of the retrospective nature of this research and its anonymity, the study did not require personal information or explicit agreement of the patients. Patients admitted at the Lausanne University Hospital received systematic information about the use of de-identified anonymous data for the purpose of retrospective studies.

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Carron, PN., Mabire, C., Yersin, B. et al. Nursing home residents at the Emergency Department: a 6-year retrospective analysis in a Swiss academic hospital. Intern Emerg Med 12, 229–237 (2017). https://doi.org/10.1007/s11739-016-1459-x

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  • DOI: https://doi.org/10.1007/s11739-016-1459-x

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