Epidemiology of geriatric patients presenting to emergency departments in Europe: EGERS study

Abstract

Background and importance Patients aged 65 and above constitute a large and growing part of emergency department (ED) visits in western countries. Objective The primary aim of this European prospective study was to determine the epidemiologic characteristics of elderly patients presenting to EDs across Europe. Our secondary objective was to determine the hospitalization rate, characteristics, and in-hospital mortality rates of geriatric patients presenting to EDs. Design setting and participants An observational prospective cohort study over seven consecutive days between 19 October and 30 November 2020, in 36 EDs from nine European countries. Patients aged 65 years and older presenting to EDs with any complaint during a period of seven consecutive days were included. Outcome measures Data were collected on demographics, the major presenting complaint, the presenting vital signs, comorbidities, usual medication, and outcomes after the ED, including disposition, in-hospital outcome, and the final hospital diagnosis. The patients were stratified into three groups: old (65–74 years), older (75–84 years), and oldest age (>85 years). Main results A total of 5767 patients were included in the study. The median age of the patients was 77 (interquartile range: 71–84) years. The majority presented with a non-traumatic complaint (81%) and about 90% of the patients had at least one comorbid disease and were on chronic medication. An ED visit resulted in subsequent hospital admission in 51% of cases, with 9% of patients admitted to an intensive care unit. Overall in-hospital mortality was 8%, and ED mortality was 1%. Older age was associated with a higher female proportion, comorbidities, need for home care service, history of previous falls, admission rates, length of ED, and hospital stay. Conclusion The characteristics of ED elderly patients and their subsequent hospital stay are reported in this prospective study.