Geriatrik Hastaların 72 Saat İçerisindeki Acil Servis Tekrar Başvurularının Analizi

Abstract

Amaç: Bu çalışmanın amacı, taburculuk sonrası 72 saat içinde acil servise (AS) tekrar başvuran 65 yaş ve üzeri hastaların klinik özelliklerini ve sonuçlarını incelemektir. Gereç ve Yöntemler: Bu retrospektif, tek merkezli çalışmaya, 1 Ocak 2022 ile 31 Aralık 2024 tarihleri arasında üçüncü basamak bir hastanenin acil servisine başvuran ve ≥65 yaşında olan hastalar dahil edilmiştir. Eksik kaydı olan veya planlı olarak geri çağrılan hastalar çalışma dışı bırakılmıştır. Hastaların demografik verileri, ilk ve ikinci başvuru tanıları ile konsültasyon oranları analiz edilmiştir. Bulgular: Çalışma döneminde toplam 729.214 AS başvurusunun 93.498’i (%12,8) ≥65 yaş grubundaydı. Bunlardan 377 hasta, 72 saat içinde planlanmamış şekilde yeniden AS başvurusu yapmıştır. İlk ve ikinci başvuruların en sık nedenleri karın ağrısı, nefes darlığı ve baş ağrısı olarak saptanmıştır. Vakaların %63,1’inde ikinci başvuru, ilk başvurudaki şikayetle aynıydı. İlk başvuruda hastaların %90,7’si taburcu edilirken, ikinci başvuruda %8,3’ü hastaneye yatırılmıştır. Konsültasyon oranı düşük olup, ikinci başvurularda sadece %13,5 oranında uzman görüşü alınmıştır. Hastaneye yatırılan hastalarda en sık başvuru nedenleri nefes darlığı, karın ağrısı ve inme belirtileri olmuştur. Medyan tekrar başvuru süresi 20,0 saat olarak belirlenmiştir. Sonuç: Yaşlı bireylerde kısa süreli AS tekrar başvuruları sıklıkla çözülmemiş semptomlara ve atipik klinik tablolara bağlıdır. Düşük konsültasyon oranı ve aynı semptomla yapılan yüksek orandaki tekrar başvurular, risk temelli taburculuk planlaması ile kapsamlı geriatrik değerlendirmenin acil servis ortamında önemini ortaya koymaktadır.

Keywords

• Geriatrik hasta
• acil servis
• tekrar başvuru

ANALYSIS OF GERIATRIC PATIENTS' READMISSIONS TO THE EMERGENCY MEDICINE SERVICES WITHIN 72 HOURS

Abstract

Objective: This study aimed to investigate the clinical characteristics and outcomes of patients aged 65 years and older who were readmitted to the emergency department (ED) within 72 hours of discharge. Material and Methods: This retrospective, single-center study included patients aged ≥65 years who revisited the ED of a tertiary hospital between January 1, 2022, and December 31, 2024. Patients with incomplete records or scheduled returns were excluded. Demographic data, initial and repeat visit diagnoses, and consultation rates were analyzed. Results: Of 729,214 total ED admissions during the study period, 93,498 (12.8%) involved patients aged ≥65 years. Among these, 377 patients had unscheduled ED readmissions within 72 hours. The most common reasons for both first and second admissions were abdominal pain, dyspnea, and headache. In 63.1% of cases, the second admission was due to the same complaint as the first. While 90.7% of patients were discharged during their first visit, 8.3% were hospitalized during the second. Consultation rates were low, with only 13.5% receiving specialty input during the second visit. Among hospitalized patients, dyspnea, abdominal pain, and cerebrovascular symptoms were the most frequent complaints. The median readmission interval was 20.0 hours. Conclusion: Short-term ED readmission in older adults is often related to unresolved symptoms and atypical presentations. The low rate of initial consultations and high frequency of samesymptom revisits highlight the need for improved risk-based discharge planning and comprehensive geriatric evaluation in the ED setting.

Keywords

• Geriatric patient
• emergency department
• readmission

Ethical Statement

Ethical approval was taken from Istanbul Medipol University Non-Interventional Clinical Research Ethics Committee with 23.01.2025 date and 99 number.

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