Retrospective Analysis of the Oldest-Old Patients Who Applied to the Emergency Department and Their Differences from the Young-Old And Middle-Old

Year 2023, , 20 - 24, 08.03.2023

İbrahim Toker , Ayşin Kılınç Toker , İrfan Gökçek , Emre Bulbul , Gökhan Yılmaz , Mustafa Silcan , Şaban Irmak , Mükerrem Altuntaş

https://doi.org/10.54996/anatolianjem.1119584

Abstract

Aim: Our study examined young, middle, and oldest-old patients who visited the emergency department (ED) and their differences.

Material and Methods: The research was executed retrospectively, utilizing the medical data of patients aged 65 and over who applied to the ED of a research hospital in Kayseri for the two years between January 1, 2020, and December 31, 2021. The patients were young-old, between 65 and 74 years old; aged 75 to 84 were middle-old, and those aged 85 and over were classified as oldest-old.

Results: 84415 (13.7%) older patients visited the ED during the study period. The patients’ median age was 74 years, IQRs (69- 80) and 53.9% (n=45466) were female. 53.4% of the patients were young-old, 33.4% middle-old, and 13.2% were oldest-old. 7.2% (n=6060) of the hospitalized patients were admitted to the intensive care unit, and 7.8% (n=1719) died. Among the first three reasons for admitting the patients to the ED, 20% (n=16874) had COVID-19, 14.4% (n=12131) had gastrointestinal symptoms, and 13.9% (n=11718) had circulatory system symptoms. Oldest-old patients were brought to the ED by ambulance more (38.4% vs. 50.9% vs. 63.2% p< 0.001), stayed longer in the ED (81 vs. 103 vs. 116 minutes, p<0.001), fewer discharged (76.2% vs. 69.5% vs. 66%, p<0.001) and a higher in-hospital mortality rate (6% vs. 8.1% vs. 12.4% p<0.001).

Conclusıon: We found that the length of stay in the ED, hospitalization rate, and ED and hospital mortality increased with age and were higher in oldest-old patients. We think that emergency health services should be developed according to the groups of elderly patients.

Keywords

Aged, patient outcome assessment, emergency medicine

Acil Servise Başvuran İleri-Yaşlı Hastaların Retrospektif Analizi ve Genç-Yaşlı ve Orta-Yaşlılardan Farklılıkları

Abstract

Amaç: Çalışmamızda acil servise (AS) başvuran genç, orta ve ileri yaşlı hastaları ve farklılıklarını incelemeyi amaçladık.

Gereç ve Yöntemler: Çalışma 1 Ocak 2020 ile 31 Aralık 2021 arasındaki 2 yıllık dönemde Kayseri'de bir araştırma hastanesinin AS’ e başvuran 65 yaş ve üzeri hastaların tıbbi kayıtları kullanılarak geriye dönük olarak yapıldı. Hastalar 65 ile 74 yaş arasında genç-yaşlı; yaşları 75 ile 84 arasında olanlar orta yaşlı; 85 yaş ve üzerinde olanlar ileri-yaşlı olarak sınıflandırıldı.

Bulgular: Çalışma süresi boyunca 84.415 (%13,7) yaşlı hasta AS’ e başvurdu. Hastaların yaş ortancası 74 yıl, ÇAA (69- 80) ve %53.9’ u (n=45466) kadındı. Hastaların %53,4’ ü genç-yaşlı, %33,4 orta-yaşlı ve %13,2’ si ileri-yaşlı idi. Hastaneye yatan hastaların %7,2’ sinin (n=6060) yoğun bakıma yattığı ve %7,8’ inin (n=1719) öldüğü tespit edildi. Hastaların acil servise başvuru nedenlerinde ilk üç sırada %20 ile (n=16874) COVID-19, %14,4’ ünün (n=12131) ile gastrointestinal sistem, %13,9 ile (n=11718) dolaşım sistemi semptomları vardı. İleri-yaşlı hastaların AS’ e daha fazla ambulans ile geldiği (%38,4 vs %50,9 vs % 63,2 p<0,001), AS’ de daha uzun süre kaldığı (81 vs 103 vs 116 dakika, p<0.001), daha az taburcu edildiği (%76,2 vs %69,5 vs %66, p<0.001) ve hastane içi ölüm oranın daha fazla olduğu (%6 vs %8,1 vs %12,4 p<0.001) bulundu.

Sonuç: AS kalış süresi, hastaneye yatış oranı ve AS ve hastane mortalitesinin yaşla birlikte arttığını ve ileri-yaşlı hastalarda daha yüksek olduğunu bulduk. Acil sağlık hizmetlerinin yaşlı hasta gruplarına göre geliştirilmesi gerektiğini düşünüyoruz.

Keywords

Yaşlı, hasta sonuçlarının değerlendirilmesi, acil tıp

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