scholarly journals P118: Older adults in the emergency department: a retrospective cross-sectional study of the geriatric population in Edmonton emergency departments

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S106-S107
Author(s):  
K. Morch ◽  
R. Schonnop ◽  
A. Gauri ◽  
D. Ha
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Geriatric Patient ◽  
Geriatric Patients ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Health Region ◽  
Area Of Interest ◽  
Ed Visits

Introduction: The geriatric patient population accounts for an ever increasing proportion of emergency department (ED) visits. Geriatric centered EDs are an emerging area of interest and research. Though there have been past studies looking at older patient presentations at individual hospitals, there is limited data describing geriatric presentations within an entire Canadian geographic health region. This study characterizes the population of older adults utilizing the EDs in the Edmonton Zone, a health region that comprises a total of eleven tertiary (T), urban community (UC) and rural community (RC) hospitals. Methods: This retrospective cross-sectional study targeted all patients ≥65 years presenting to the Edmonton Zone EDs between April 1, 2017 to March 31, 2018. Data was extracted from the Emergency Department Information System (EDIS) database for ten EDs in the health region. Clinical and administrative data points were extracted and examined for each site. Results: We analyzed 100,813 ED geriatric patient visits during our study period, accounting for 18.7% of total ED visits to the Edmonton Zone. The five most common triage complaints at ED presentation were shortness of breath, abdominal pain, chest pain with cardiac features, general weakness, and back pain. CTAS scores 1-3 were assigned to 77.8% of geriatric presentations (T: 86.3%, UC: 77.4%, RC: 60.9%). 27.3% of geriatric patients had presented to an ED within the past 30 days (T: 30.0%, UC: 25.4%, RC: 27.7%). On average, 35.3% of older adult ED visits involved a consultation (T: 51.7%, UC 30.8%, RC 14.6%) and approximately 25% of geriatric patients were admitted to hospital during their ED visit (T: 42.8%, UC: 19.4%, RC: 7.1%). The average length of stay (LOS) in the ED (hh:mm) was 10:19 (T: 10:24, UC: 11:38, RC: 5:43). Overall, 2.4% of all geriatric patients left an ED without being seen after initial registration (T: 2.7%, UC: 2.2%, RC: 2.1%). Conclusion: Older adults represent a significant proportion of the ED visits in the Edmonton Zone. The triage acuity, LOS, re-presentation, consultation and admission rates varied based on the type of ED, which has implications for resource allocation within the health region. Our results can also direct future targeted initiatives and quality improvement projects to the various types of EDs in the Edmonton Zone, and facilitate planning of ED services for older adults in other health regions who have a similar geographic distribution of care sites.

Usability of a tablet computer designed for older adults: a qualitative approach based on an intra-hospital living-lab for healthcare (Preprint)

2020 ◽  
Author(s):  
Guillaume Sacco ◽  
Pauline Carliez ◽  
Frédéric Noublanche ◽  
Romain Simon ◽  
Anne Renaudin ◽  
...  
Keyword(s):  
Older Adults ◽  
Geriatric Patients ◽  
Healthcare Professionals ◽  
Cross Sectional Study ◽  
Satisfaction Score ◽  
Tablet Computer ◽  
Sectional Study ◽  
Cross Sectional ◽  
System Usability Scale ◽  
Perceived Usability

BACKGROUND Usability is the keystone in the evolution of tablet technology in healthcare. The Ardoiz® tablet has been designed with a simplified interface for older adults. OBJECTIVE To assess the perceived usability and satisfaction of the Ardoiz® tablet. METHODS We conducted a mixed methods with cross-sectional study using System Usability Scale (SUS), satisfaction score and workshops, including geriatric patients, healthcare professional and caregivers. RESULTS Between September 25, 2019 and March 11, 2020, 58 participants were included in a cross-sectional study (including 38 patients, mean ±SD 85±6 years, 66% women), 26 in workshops (including 5 patients, mean ±SD 86.4±2.9, 40% women). The SUS was 74±12/100, the satisfaction score was 2.8±0.9/4, with 59% of satisfied participants with the use of Ardoiz® pads. The intent to acquire remained low with 18% (n=6) of participants who would be interested in acquiring the tablet. This tablet computer seemed to be difficult to use by geriatric patients and healthcare professionals, mainly because of its complex homepage. Nevertheless, former caregivers and healthcare professionals thought that the tablet could be of great interest to hospitals for leisure and medical use. The main feedback in order to improve the tablet is to simplify the home page with fewer and more static icons (without switching). CONCLUSIONS Notwithstanding the usability of the tablet, the intent to acquire of Ardoiz® tablet remained low. The interface should be simplified for older adults in order to improve usability and adherence. CLINICALTRIAL NCT04091152

scholarly journals A cross-sectional study to investigate motivation for physical activity in a sample of Iranian community-dwelling older adults

2020 ◽  
Vol 10 (2) ◽  
pp. 135-141
Author(s):  
Seyed Alireza Derakhshanrad ◽  
Emily Piven ◽  
Bahareh Zeynalzadeh Ghoochani
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Cross Sectional Study ◽  
Ordinal Regression ◽  
Community Dwelling ◽  
Sectional Study ◽  
Cross Sectional ◽  
Convenience Sample ◽  
Area Of Interest ◽  
Community Dwelling Older Adults

Background: On the basis of the Social-Ecological Model, there are assumed to be three sources of motivation – intrapersonal, interpersonal, and community motivation – that prompt older adults to participate in physical activity (PA). These three motivational sources can lead to PA behavior adherence. Little empirical research exists that investigates which motivational source is more influential in older adults’ adherence to PA, thus creating an area of interest for this research. Methods: A cross-sectional study was used to investigate the relationship between levels of PA and different sources of motivation. The convenience sample of 140 community-dwelling older adults, aged 60 and greater, living in Shiraz, Iran agreed to complete self-reported questionnaires,to measure motivation and PA. Five statistical tests were used: Independent-samples t test, one way ANOVA, Pearson correlation coefficient, chi-square, and ordinal regression. Results: Ordinal regression indicated that gender (P = 0.001, CI: 0.523-2.115) and intrapersonal motivation (P < 0.001, CI: 0.038-0.126) were useful predictors of variations in the levels of PA. Compared to males, females engaged in PA with less frequency (P = 0.006). Community motivation decreased with age (r = - 0.213, P < 0.05). There were no significant relationships between age, educational level, health status, and PA (P > 0.05). Conclusion: Interpersonal and community motivation were insignificant factors for PA participation, perhaps due to non-facilitating environment. Future research should be conducted to investigate the environmental issues that hinder PA participation in older adults.

scholarly journals COVID-19 Pandemic Impact on Emergency Department Visits and Quality of Service: A Comparative Cross-Sectional Study in a Tertiary Centre

2021 ◽  
pp. 471-483
Author(s):  
Maram Mohammed Jaboua ◽  
Warif Jameel Abdulhaq ◽  
Nada Saeed Almuntashiri ◽  
Sarah Saud Almohammdi ◽  
Asayel Qeblan Aldajani ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cross Sectional Study ◽  
Emergency Department Visits ◽  
Critical Conditions ◽  
Sectional Study ◽  
Cross Sectional ◽  
Coronary Syndrome ◽  
Number Of Patients ◽  
Ed Visits

Background: The COVID-19 pandemic has contributed to a devastating impact on emergency departments worldwide, resulting in a global crisis with various health consequences. We aimed to evaluate this impact on an emergency department (ED) visit of critical conditions such as Acute Coronary Syndrome (ACS), Cerebrovascular accident (CVA), Sepsis and Febrile neutropenia (FN), and to assess the quality of the ED after new adaptive measures were applied. Methods: This is a comparative cross-sectional study to assess the number of patients who presented to the ED of King Abdullah Medical city with the specified diagnosis. We collected data via the E-medical records. We compared the data over three periods pre-lockdown, lockdown and post lockdown in years 2019-2021. For quality measurement, Adaa (Ministry of Health's program) was used to calculate the percentage of patients who stayed 4 hours or less in the ED. Results: The total number of ED visits in the specified periods of study was 8387. The total numbers of patients for 2019, 2020, and 2020 respectively were 2011 (, ACS 70.4%, CVA 16.3%, sepsis and FN 13.3%.), 2733 (ACS 73.1%, CVA 9.9%, sepsis and FN 17.0%), and 3643 (ACS 64.0%, CVA 19.4%, sepsis and FN 16.7). The average percentage of patients who stayed 4 hours or less in the ED was 60% and 57.5% for 2020 and 2021, respectively. Conclusion: Although we expected reductions in ED visits during COVID-19 periods, we found that visits were rising through the years 2019-2021.

Association of asthma with osteopenia, osteoporosis, osteomalacia, and fractures

2020 ◽  
Vol 41 (2) ◽  
pp. 112-119 ◽  
Author(s):  
Mohammed S. Shaheen ◽  
Jonathan I. Silverberg
Keyword(s):  
Emergency Department ◽  
The United States ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Pathologic Fractures ◽  
Ed Visits ◽  
National Emergency ◽  
The Relationship

Background: Previous studies that examined the relationship between asthma, osteoporosis, and pathologic fractures found conflicting results. Objective: To determine whether asthma is associated with osteopenia, osteoporosis, osteomalacia, and fractures in U.S. adults. Methods: A cross-sectional study of 198,102,435 children and adults, including 10,129,307 with asthma, from the 2006‐2012 National Emergency Department Sample, which includes a representative 20% sample of emergency department (ED) visits throughout the United States. Results: ED visits of patients with versus without asthma were associated with higher odds of osteopenia (7 of 7 years: multivariable logistic regression of all years pooled; adjusted odds ratio [aOR] 1.45 [95% confidence interval {CI}, 1.41‐1.50]), osteoporosis (7 of 7 years: aOR 1.85 [95% CI, 1.82‐1.88]), osteomalacia (7 of 7 years: aOR 2.00 [95% CI, 1.61‐2.49]), and pathologic fractures (7 of 7 years: OR 1.24 [95% CI, 1.20‐1.27]). Patients with asthma and with long-term glucocorticoid use had higher odds of osteoporosis, osteopenia, osteomalacia, and fractures compared with patients with asthma and without long-term glucocorticoid use. Patients with asthma and with fractures incurred significantly more inpatient admissions, and higher costs of ED and inpatient care. Conclusion: ED visits with asthma were associated with osteopenia, osteoporosis, osteomalacia, and pathologic fractures.

scholarly journals Ability of Older Adults to Report Elder Abuse: An Emergency Department–Based Cross‐Sectional Study

2020 ◽  
Vol 68 (1) ◽  
pp. 170-175
Author(s):  
Natalie L. Richmond ◽  
Sheryl Zimmerman ◽  
Bryce B. Reeve ◽  
Joseph A. Dayaa ◽  
Mackenzie E. Davis ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Elder Abuse ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Priorities of Care Among Older Adults in the Emergency Department: A Cross-sectional Study

2016 ◽  
Vol 23 (3) ◽  
pp. 362-365 ◽  
Author(s):  
Katherine M. Hunold ◽  
Gregory F. Pereira ◽  
Christopher W. Jones ◽  
Cameron G. Isaacs ◽  
Valerie A. Braz ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals Increasing false positive diagnoses may lead to overestimation of stroke incidence, particularly in the young: a cross-sectional study

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Abhinav J. Appukutty ◽  
Lesli E. Skolarus ◽  
Mellanie V. Springer ◽  
William J. Meurer ◽  
James F. Burke
Keyword(s):  
Older Adults ◽  
False Positive ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Primary Diagnosis ◽  
Sectional Study ◽  
Cross Sectional ◽  
Stroke Incidence ◽  
Ed Visits ◽  
Over Time

Abstract Background Stroke incidence is reportedly increasing in younger populations, although the reasons for this are not clear. We explored possible reasons by quantifying trends in neurologically focused emergency department (ED) visits, classification of stroke vs. TIA, and imaging use. Methods We performed a retrospective, serial, cross-sectional study using the National Hospital Ambulatory Medical Care Survey to examine time trends in age-stratified primary reasons for visit, stroke/TIA diagnoses, and MRI utilization from 1995 to 2000 and 2005–2015. Results Five million eight hundred thousand ED visits with a primary diagnosis of stroke (CI 5.3 M–6.4 M) were represented in the data. The incidence of neurologically focused reason for visits (Neuro RFVs) increased over time in both the young and in older adults (young: + 111 Neuro RFVs/100,000 population/year, CI + 94 − + 130; older adults: + 70 Neuro RFVs/100,000 population/year, CI + 34 − + 108). The proportion of combined stroke and TIA diagnoses decreased over time amongst older adults with a Neuro RFV (OR 0.95 per year, p < 0.01, CI 0.94–0.96) but did not change in the young (OR 1.00 per year, p = 0.88, CI 0.95–1.04). Within the stroke/TIA population, no changes in the proportion of stroke or TIA were identified. MRI utilization rates amongst patients with a Neuro RFV increased for both age groups. Conclusions We found, but did not anticipate, increased incidence of neurologically focused ED visits in both age groups. Given the lower pre-test probability of a stroke in younger adults, this suggests that false positive stroke diagnoses may be increasing and may be increasing more rapidly in the young than in older adults.

scholarly journals Emergency department visits and hospitalisations for emergent asthmatic symptoms from 2014 to 2016: cross-sectional study in Korea

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e036237
Author(s):  
Kyungseon Choi ◽  
Sola Han ◽  
Hae Sun Suh
Keyword(s):  
Emergency Department ◽  
Age Groups ◽  
International Classification Of Diseases ◽  
Cross Sectional Study ◽  
Emergency Department Visits ◽  
Resource Utilisation ◽  
Main Diagnosis ◽  
Sectional Study ◽  
Cross Sectional ◽  
Ed Visits

ObjectiveTo evaluate the characteristics of emergent patients with asthma who visited emergency departments (EDs) in Korea, and the consequences of these visits.DesignRetrospective cross-sectional study.SettingWe used data from the National Emergency Department Information System database from 2014 to 2016. The data included reports collected from 408 EDs in Korea.ParticipantsWe analysed the ED cases for asthma-related emergent symptoms that met the following inclusion criteria: (1) had a main diagnosis code of asthma (International Classification of Diseases 10th Revision code: J45/J46), and (2) recorded as an emergent symptom in the EDs.ResultsDuring 2014–2016, there were 58 713 ED visits related to an asthma diagnosis with emergent symptoms. Following an ED visit, 31.69% were hospitalised, of which 89.88% were admitted to the general wards, and 10.12% to the intensive care units (ICUs). More than 50% of the hospitalised cases included in the group ≥70 years of age. The incidence of death during hospitalisation generally increased with age and the proportion of death in ICU exceeded 10% among the group ≥70 years. The ratio of ICU/general ward admission at the arrival time of 0–03:00, in the ≥60 years age group was the highest compared with other times of the day and age groups.ConclusionsWe found that among all age groups, ED visits by older patients resulted in more ICU admissions. Our results can help in providing a better understanding of medical resource utilisation by emergent patients with asthma.

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