Clinical characteristics of under-triaged elderly patients in the emergency department: a Korea public hospital observational study

Abstract

Abstract Background Elderly patients are more likely to be undertriaged because they often suffer from multiple diseases and complain of non-specific symptoms. Therefore, it is necessary to identify the characteristics of undertriaged elderly patients in emergency departments (EDs). Methods This descriptive study retrospectively reviewed and analyzed the electronic medical records of elderly patients who visited the ED of a general hospital in Seoul between January and December 2019. Results Approximately 29% (n = 4,823) of elderly patients who visited the ED during the study period were classified as CTAS level 4 or 5, and approximately 8% (n = 397) were undertriaged. Approximately 73% (n = 288) of patients were hospitalized after visiting the ED. The characteristics of the undertriaged elderly patients were nervous system symptoms such as dizziness and headache (28.8%), cardiopulmonary symptoms such as chest discomfort, palpitations, and abdominal pain (28.4%), head trauma (12.8%), and respiratory symptoms such as cough and dyspnea (12.5%). Conclusion ED triage nurses should carefully triage elderly patients because their chief complaints can be non-specific. In particular, when elderly patients visit the ED, dizziness, abnormal pain, chest discomfort, palpitations, and head trauma can occur in intensive care units, so they must be carefully classified.