Predictors of return visits to the emergency department among different age groups of older adults
To identify predictors of 30-day emergency department (ED) return visits in patients age 65–79 years and age ≥ 80 years. This was a cohort study of older adults who presented to the ED over a 1-year period. A mixed-effects logistic regression model was used to identify predictors for returning to th...
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Published in: | The American journal of emergency medicine Vol. 46; pp. 241 - 246 |
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Main Authors: | , , , , , |
Format: | Journal Article |
Language: | English |
Published: |
Philadelphia
Elsevier Inc
01-08-2021
Elsevier Limited |
Subjects: | |
Online Access: | Get full text |
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Summary: | To identify predictors of 30-day emergency department (ED) return visits in patients age 65–79 years and age ≥ 80 years.
This was a cohort study of older adults who presented to the ED over a 1-year period. A mixed-effects logistic regression model was used to identify predictors for returning to the ED within 30 days. We stratified the cohort into those aged 65–79 years and aged ≥80 years. Adjusted odds ratios (aORs) with 95% confidence intervals (CI) were reported. This study adhered to the STROBE reporting guidelines.
A total of 21,460 ED visits representing 14,528 unique patients were included. The overall return rate was 15% (1998/13,300 visits) for age 65–79 years, and 16% (1306/8160 visits) for age ≥ 80 years. A history of congestive heart failure (CHF), dementia, or prior hospitalization within 2 years were associated with increased odds of returning in both age groups (for age 65–79: CHF aOR 1.36 [CI 1.16–1.59], dementia aOR 1.27 [CI 1.07–1.49], prior hospitalization aOR 1.36 [CI 1.19–1.56]; for age ≥ 80: CHF aOR 1.32 [CI 1.13–1.55], dementia aOR 1.22 [CI 1.04–1.42], and prior hospitalization aOR 1.27 [CI 1.09–1.47]). Being admitted from the ED was associated with decreased odds of returning to the ED within 30 days (aOR 0.72 [CI 0.64–0.80] for age 65–79 years and 0.72 [CI 0.63–0.82] for age ≥ 80).
Age alone was not an independent predictor of return visits. Prior hospitalization, dementia and CHF were predictors of 30-day ED return. The identification of predictors of return visits may help to optimize care transition in the ED.
•The rates of return visits were similar in different age groups of older adults;•The diagnoses of congestive heart failure and dementia were associated with increased 30-day ED return visits in both age groups;•The diagnoses of coronary artery disease, diabetes and cancer were associated with increased 30-day ED return visits only among the age 65–79.•This cohort study showed the importance of evaluating predictors of ED return visits across the geriatric age spectrum. |
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Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 0735-6757 1532-8171 |
DOI: | 10.1016/j.ajem.2020.07.042 |