scholarly journals Trends of chronic illness in emergency department admissions among elderly adults in a tertiary hospital over ten years

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhongxun Hu ◽  
Fahad Javaid Siddiqui ◽  
Qiao Fan ◽  
Sherman W. Q. Lian ◽  
Nan Liu ◽  
...  
Keyword(s):  
Emergency Department ◽  
Chronic Illness ◽  
Elderly Patients ◽  
Chronic Conditions ◽  
National Level ◽  
Aging Population ◽  
The Elderly ◽  
Tertiary Hospital ◽  
Care Hospital ◽  
Emergency Admissions

Abstract Background This study aimed to determine to what extent an aging population and shift to chronic illness has contributed to emergency admissions at a tertiary care hospital over ten years. Methods This was a retrospective observational study performed using a database of all emergency admissions from the Emergency Department (ED) at a single tertiary hospital in Singapore during a ten-year period (January 1st, 2008 to December 31st, 2017). Emergency admissions were defined as ED visits with inpatient admission as the disposition. This study analyzed the trends of demographics, pre-existing comorbidities, chronic conditions or ambulatory care sensitive conditions (ACSC) of all patients who underwent emergency admissions in Singapore General Hospital. Results A total of 446,484 emergency records were included. For elderly patients, the proportions of them had pre-existing multimorbidity at the time of undergoing emergency admissions were found to be lower at the end the 10-year study period relative to the beginning of the study period. The proportions of emergency admissions whose ED primary diagnoses were categorized as chronic conditions and certain chronic ACSC including chronic obstructive pulmonary disease, congestive heart failure, diabetes complications, and epilepsy also decreased for elderly patients over the 10-year study period. Conclusions In Singapore, despite a rapidly aging population, there have been surprisingly lower proportions of chronic conditions, pre-existing comorbidities, and chronic ACSC among the elderly emergency admissions. This is possibly consistent with an overall improved management of the chronic conditions among the elderly population. Future studies should include similar studies at the national level and comparison with other healthcare settings in different countries.

Impact of an Aging Population and Shift to Chronic Illness on Emergency Department Admissions in a Tertiary Hospital Over Ten Years

2021 ◽  
Author(s):  
Zhongxun Hu ◽  
Fahad Javaid Siddiqui ◽  
Qiao Fan ◽  
Sherman WQ Lian ◽  
Nan Liu ◽  
...  
Keyword(s):  
Emergency Department ◽  
Chronic Illness ◽  
Elderly Patients ◽  
Chronic Conditions ◽  
Elderly Population ◽  
Aging Population ◽  
The Elderly ◽  
Tertiary Hospital ◽  
Ageing Population ◽  
Emergency Admissions

Abstract Background: This study aimed to determine to what extent an aging population and shift to chronic illness has contributed to emergency admissions at a tertiary care hospital over ten years.Methods: This was a retrospective observational study performed using a database of all emergency admissions from the Emergency Department (ED) at a single tertiary hospital in Singapore during a ten-year period (January 1st, 2008 to December 31st, 2017). Emergency admissions were defined as ED visits with inpatient admission as the disposition. This study analyzed the trends of demographics, pre-existing comorbidities, chronic conditions or ambulatory care sensitive conditions (ACSC) of all patients who underwent emergency admissions in SGH. Results: A total of 446,484 emergency records were included. While the annual number of emergency admissions increased by 22% from 2008 to 2017, the rate of emergency admissions for the Singapore elderly population (aged >65 years) had a relative decrease of 15% during the same period. For elderly patients, lower proportions of them had pre-existing multimorbidity at the time of undergoing emergency admissions. The proportions of emergency admissions whose ED primary diagnoses were categorized as chronic conditions and certain chronic ACSC including chronic obstructive pulmonary disease, congestive heart failure, diabetes complications, and epilepsy also decreased for elderly patients. Conclusions: In Singapore, despite a rapidly ageing population, there have been surprisingly fewer chronic conditions, pre-existing comorbidities, and chronic ACSC among the elderly emergency admissions. This is possibly consistent with an overall improved management of the chronic conditions among the elderly population and will be interesting to compare with other healthcare settings in different countries in future studies.

Supportive Care Considerations for Older Adults With Cancer

2014 ◽  
Vol 32 (24) ◽  
pp. 2627-2634 ◽  
Author(s):  
Arash Naeim ◽  
Matti Aapro ◽  
Rashmi Subbarao ◽  
Lodovico Balducci
Keyword(s):  
Elderly Patients ◽  
Supportive Care ◽  
Chronic Conditions ◽  
Treatment Options ◽  
The Elderly ◽  
Strongly Correlated ◽  
Lifestyle Management ◽  
Patients With Cancer ◽  
Age Appropriate

The treatment of cancer presents specific concerns that are unique to the growing demographic of elderly patients. Because the incidence of cancer is strongly correlated with aging, the expansion of supportive care and other age-appropriate therapies will be of great importance as the population of elderly patients with cancer increases in the coming years. Elderly patients are especially likely to experience febrile neutropenia, complications from chemotherapy-induced nausea, anemia, osteoporosis (especially in patients diagnosed with breast or prostate cancer), depression, insomnia, and fatigue. These issues are often complicated by other chronic conditions related to age, such as diabetes and cardiac disease. For many patients, symptoms may be addressed both through lifestyle management and pharmaceutical approaches. Therefore, the key to improving quality of life for the elderly patient with cancer is an awareness of their specific needs and a familiarity with emergent treatment options.

scholarly journals The Success Rate of Endotracheal Intubation in the Emergency Department of Tertiary Care Hospital in Ethiopia, One-Year Retrospective Study

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Ayalew Zewdie ◽  
Dejene Tagesse ◽  
Selam Alemayehu ◽  
Tesfaye Getachew ◽  
Menbeu Sultan
Keyword(s):  
Emergency Department ◽  
Success Rate ◽  
Endotracheal Intubation ◽  
Addis Ababa ◽  
Tertiary Care ◽  
Tertiary Hospital ◽  
Rapid Sequence Intubation ◽  
Care Hospital ◽  
Success Rates ◽  
First Pass

Background. Emergency medical care starts with airway assessment and intervention management. Endotracheal intubation is the definitive airway management in the emergency department (ED) for patients requiring a definitive airway. Successful first pass is recommended as the main objective of emergency intubation. There exists no published research regarding the success rates or complications that occur within Ethiopian hospitals emergency department intubation practice. Objective. This study aimed to assess the success rate of emergency intubations in a tertiary hospital, Addis Ababa, Ethiopia. Methodology. This was a single institute retrospective documentation review on intubated patients from November 2017 to November 2018 in the emergency department of Addis Ababa Burn Emergency and Trauma Hospital. All intubations during the study period were included. Data were collected by trained data collectors from an intubation documentation sheet. Result. Of 15,933 patients seen in the department, 256 (1.6%) patients were intubated. Of these, 194 (74.9%) were male, 123 (47.5%) sustained trauma, 65 (25.1%) were medical cases, and 13(5%) had poisoning. The primary indications for intubation were for airway protection (160 (61.8%)), followed by respiratory failure (72(27.8%)). One hundred and twenty-nine (49.8%) had sedative-only intubation, 110 (42.5%) had rapid sequence intubation, and 16 (6.2%) had intubation without medication. The first-pass success rate in this sample was 70.3% (180/256), second-pass 21.4% (55/256), and third-pass 7.4% (19/256), while the overall success rate was 99.2% (254/256). Hypoxia was the most common complication. Conclusion. The intubation first-pass success rate was lower than existing studies, but the overall intubation success rate was satisfactory.

scholarly journals Evaluation of the awareness of the physicians on negligence and abuse of the elderly patients admitted to emergency department

2018 ◽  
Vol 3 (3) ◽  
pp. 82-90
Author(s):  
Saffet Özdemir ◽  
Burak Katıpoglu ◽  
Togay Evrın ◽  
Fatma Akkus Özdemir ◽  
Eylem Kuday Kaykısız ◽  
...  
Keyword(s):  
Emergency Department ◽  
Elderly Patients ◽  
The Elderly

scholarly journals Laparoscopic Cholecystectomy in the Elderly: An Experience at a Tertiary Care Hospital in Western Nepal

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Tika Ram Bhandari ◽  
Sudha Shahi ◽  
Rajeev Bhandari ◽  
Rajesh Poudel
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Elderly Patients ◽  
Medical Records ◽  
Elderly Population ◽  
Tertiary Care ◽  
Young Patients ◽  
The Elderly ◽  
Young Group ◽  
Perioperative Outcomes ◽  
Care Hospital

Background. The incidence of gallstone increases with increasing age. No studies have been reported in the elderly population with laparoscopic cholecystectomy from developing nations. The aim of this study was to compare perioperative outcomes of laparoscopic cholecystectomy between the elderly (≥60 years old) and the young (<60 years old).Methods. From July 2015 to June 2016, a retrospective review of medical records of 78 elderly patients (≥60 years old) and 164 young patients (<60 years old) who underwent laparoscopic cholecystectomy was done. The patients’ demographics and perioperative outcomes were analyzed.Results. Median ages were 65 years (range: 60–80) and 45 years (range: 21–59) for the elderly group and the young group. The majority of patients were female (62.8 and 72%). There were no significant differences in the conversion rate (9 and 7.9%,P=0.78), postoperative complications (17.9 and 14.6%,P=0.50), and length of stay in the hospital (4 days for both groups,P=0.35) between the two groups. There was no mortality in either of the groups.Conclusion. Our results of laparoscopic cholecystectomy in elderly patients are comparable with those in young patients. Therefore, laparoscopic cholecystectomy is safe even in the elderly population.

A Successful Strategy for Recruiting Elderly Patients with Mild Hyperparathyroidism into a Randomized Controlled Trial

2010 ◽  
Vol 2 (1) ◽  
pp. 29-32
Author(s):  
Nancy D Perrier ◽  
Joshua MV Mammen ◽  
Safia Rafeeq ◽  
Holly Holmes ◽  
Nancy E Thompson ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Elderly Patients ◽  
Chronic Conditions ◽  
Older Persons ◽  
Medical Condition ◽  
Controlled Trial ◽  
Treatment Strategies ◽  
The Elderly ◽  
Treatment Trials ◽  
Surgical Trial

ABSTRACT Objective Effective strategies that improve the inclusion of older persons in clinical trials are needed to better characterize and treat chronic conditions that affect elderly patients. Especially challenging is the recruitment of the elderly into treatment trials for chronic conditions with vague symptoms, as is the case for primary hyperparathyroidism. The incidence of primary hyperparathyroidism increases with age, and the disease may present with symptoms that are difficult to objectively measure but contribute to decline of function and quality of life. Understanding the optimal treatment of primary hyperparathyroidism necessitates inclusion of greater numbers of older persons in treatment trials. As a part of our study of asymptomatic hyperparathyroidism, we also devised a strategy to recruit and retain older persons in a randomized surgical trial for primary hyperparathyroidism. Design Individuals greater than 60 years of age who did not meet established criteria for surgical intervention for primary hyperparathyroidism were offered the opportunity to participate in a clinical study evaluating the benefits of immediate minimally invasive parathyroidectomy (MIP) vs medical observation. Intervention Strategies to encourage participation and compliance included compensation for incidental expenses of lodging, meals, and travel for clinic visits related to the study as well as regular interaction with an experienced study coordinator. Measurements Study participation included formal neurocognitive evaluations, functional magnetic resonance brain imaging, functional performance batteries, and sleep studies over a 6-month period. Results Thirty-five individuals ranging in age from 61 to 79 years were screened for participation. Nine individuals were ineligible, and 14 of eligible individuals consented to participate in the study. Among the 12 eligible individuals who declined to participate, the most common reason identified was distance to study center. Conclusion We report an effective strategy to recruit a substantial proportion of eligible elderly individuals as subjects in a study of treatment strategies for a medical condition with few overt symptoms.

scholarly journals Evaluation of Potential Drug-Drug Interactions with Medications Prescribed to Geriatric Patients in a Tertiary Care Hospital

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Varsha Shetty ◽  
Mukta N. Chowta ◽  
Nithyananda Chowta K ◽  
Ashok Shenoy ◽  
Ashwin Kamath ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Drug Interactions ◽  
Tertiary Care ◽  
Educational Status ◽  
The Elderly ◽  
Risk Category ◽  
Care Hospital ◽  
Potential Drug ◽  
Cross Sectional ◽  
The Mean

Background and Objectives. The drugs most commonly implicated in major potential interactions are those used in the day-to-day clinical management of elderly patients with chronic diseases. This study is planned to evaluate the profile of drug-drug interactions in the medications prescribed to elderly population and also to identify the possible predictors for potential drug-drug interactions in the elderly. Methods. This cross-sectional study included patients aged above 60 years with a minimum of two drugs in the prescriptions. Data were collected from medical prescriptions and patients' medical records. The data collected included demographic characteristics such as age, gender, height, weight, educational status, socioeconomic status, medical history, and medications prescribed. The prescriptions were analyzed for the potential drug interactions using Lexi-Interact™ Online, an online software to check drug-drug interactions. Results. A total of 209 patients were included in the study, among them 104 (49.8%) were males and 105 (50.2%) were females. The mean number of medications received was 6.53 ± 2.15 per prescription. Around 138 (66%) patients received more than six medications. The mean number of potential drug interactions seen in the prescription of these patients was 3.17 ± 2.78. Around 18.2% patients had more than five drug interactions. Major drug interactions were observed in 21.42% of cases. Around 3.02% of drug interactions belonged to risk category X, i.e., to be avoided. Logistic regression analysis showed that age above 70 years was associated with the presence of drug interactions. Increased number of medication was independently associated with the occurrence of drug interactions. The presence of drug interactions was not associated with increased number of comorbidities. Conclusion. A significant number of potential drug-drug interactions were seen in the prescriptions of elderly patients. Increasing age and polypharmacy were identified as the predictors of potential drug interactions.

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