Leveraging emergency department visits to connect older adults at risk for malnutrition and food insecurity to community resources: design and protocol development for the BRIDGE study

Abstract Food insecurity is an under-recognized geriatric syndrome that has extensive implications in the overall health and well-being of older adults. Understanding the impact of food insecurity in older adults is a first step in identifying at-risk populations and provides a framework for potential interventions in both hospital and community-based settings. This symposium will provide an overview of current prevalence rates of food insecurity using large population-based datasets. We will present a summary indicator that expands measurement to include the functional and social support limitations (e.g., community disability, social isolation, frailty, and being homebound), which disproportionately impact older adults, and in turn their rate and experience of food insecurity and inadequate food access. We will illustrate using an example of at-risk seniors the association between sarcopenia, the age-related loss of muscle mass and function, with rates of food security in the United States. The translational aspect of the symposium will then focus on identification of psychosocial and environmental risk factors including food insecurity in older veterans preparing for surgery within the Veterans Affairs Perioperative Optimization of Senior Health clinic. Gaining insights into the importance of food insecurity will lay the foundation for an intervention for food insecurity in the deep south. Our discussant will provide an overview of the implications of these results from a public health standpoint. By highlighting the importance of food insecurity, such data can potentially become a framework to allow policy makers to expand nutritional programs as a line of defense against hunger in this high-risk population.

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Derivation of a nomogram to estimate probability of revisit in at-risk older adults discharged from the emergency department

Internal and Emergency Medicine ◽

10.1007/s11739-012-0895-5 ◽

2013 ◽

Vol 8 (3) ◽

pp. 249-254 ◽

Cited By ~ 17

Author(s):

Glenn Arendts ◽

Sarah Fitzhardinge ◽

Karren Pronk ◽

Marani Hutton ◽

Yusuf Nagree ◽

...

Keyword(s):

Older Adults ◽

At Risk ◽

Emergency Department

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Head Trauma from Falling Increases Subsequent Emergency Department Visits More Than Other Fall-Related Injuries in Older Adults

Journal of the American Geriatrics Society ◽

10.1111/jgs.14041 ◽

2016 ◽

Vol 64 (4) ◽

pp. 870-874 ◽

Cited By ~ 11

Author(s):

Lauren T. Southerland ◽

Julie A. Stephens ◽

Shari Robinson ◽

James Falk ◽

Laura Phieffer ◽

...

Keyword(s):

Older Adults ◽

Emergency Department ◽

Head Trauma ◽

Emergency Department Visits

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Improving Identification of Seniors at Risk Tool Adherence to Identify Emergency Department Readmissions in Older Adults

10.22371/07.2021.048 ◽

2021 ◽

Author(s):

◽

Joy Gao

Keyword(s):

Older Adults ◽

At Risk ◽

Emergency Department

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Emergency Department Visits for Opioid Overdoses Among Patients With Cancer

JNCI Journal of the National Cancer Institute ◽

10.1093/jnci/djz233 ◽

2019 ◽

Vol 112 (9) ◽

pp. 938-943 ◽

Cited By ~ 5

Author(s):

Vikram Jairam ◽

Daniel X Yang ◽

James B Yu ◽

Henry S Park

Keyword(s):

At Risk ◽

Emergency Department ◽

Statistical Tests ◽

Temporal Trends ◽

The United States ◽

Emergency Department Visits ◽

Multivariable Logistic Regression Analysis ◽

Opioid Overdose ◽

Patients With Cancer ◽

Ed Visits

Abstract Background Patients with cancer may be at risk of high opioid use due to physical and psychosocial factors, although little data exist to inform providers and policymakers. Our aim is to examine overdoses from opioids leading to emergency department (ED) visits among patients with cancer in the United States. Methods The Healthcare Cost and Utilization Project Nationwide Emergency Department Sample was queried for all adult cancer-related patient visits with a primary diagnosis of opioid overdose between 2006 and 2015. Temporal trends and baseline differences between patients with and without opioid-related ED visits were evaluated. Multivariable logistic regression analysis was used to identify risk factors associated with opioid overdose. All statistical tests were two-sided. Results Between 2006 and 2015, there were a weighted total of 35 339 opioid-related ED visits among patients with cancer. During this time frame, the incidence of opioid-related ED visits for overdose increased twofold (P < .001). On multivariable regression (P < .001), comorbid diagnoses of chronic pain (odds ratio [OR] 4.51, 95% confidence interval [CI] = 4.13 to 4.93), substance use disorder (OR = 3.54, 95% CI = 3.28 to 3.82), and mood disorder (OR = 3.40, 95% CI = 3.16 to 3.65) were strongly associated with an opioid-related visit. Patients with head and neck cancer (OR = 2.04, 95% CI = 1.82 to 2.28) and multiple myeloma (OR = 1.73, 95% CI = 1.32 to 2.26) were also at risk for overdose. Conclusions Over the study period, the incidence of opioid-related ED visits in patients with cancer increased approximately twofold. Comorbid diagnoses and primary disease site may predict risk for opioid overdose.

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Primary diagnoses and outcomes of emergency department visits in older people with dementia: a hospital-based retrospective study in Taiwan

International Psychogeriatrics ◽

10.1017/s1041610219000395 ◽

2019 ◽

Vol 32 (1) ◽

pp. 97-104

Author(s):

Pei-Chao Lin ◽

Li-Chan Lin ◽

Hsiu-Fen Hsieh ◽

Yao-Mei Chen ◽

Pi-Ling Chou ◽

...

Keyword(s):

Older Adults ◽

Emergency Department ◽

Retrospective Study ◽

Older People ◽

Hospital Admission ◽

Emergency Department Visits ◽

Urban Setting ◽

Research Database ◽

Patient Records ◽

People With Dementia

ABSTRACTObjectives:The objectives of this study were to investigate the primary diagnoses and outcomes of emergency department visits in older people with dementia and to compare these parameters with those in older adults without dementia.Design and Setting:This hospital-based retrospective study retrieved patient records from a hospital research database, which included the outpatient and inpatient claims of two hospitals.Participants:The patient records were retrieved from the two hospitals in an urban setting. The inclusion criteria were all patients aged 65 and older who had attended the two hospitals as an outpatient or inpatient between January 1, 2009, and December 31, 2016. Patients with dementia were identified to have at least three reports of diagnostic codes, either during outpatient visits, during emergency department visits, or in hospitalized database records. The other patients were categorized as patients without dementia.Measurements:The primary diagnosis during the emergency department visit, cost of emergency department treatment, cost of hospital admission, length of hospital stay, and diagnosis of death were collected.Results:A total of 149,203 outpatients and inpatients aged 65 and older who were admitted to the two hospitals were retrieved. The rate of emergency department visits in patients with dementia (23.2%) was lower than that in those without dementia (48.6%). The most frequent primary reason for emergency department visits and the main cause of patient death was pneumonia. Patients with dementia in the emergency department had higher hospital admission rates and longer hospital stays; however, the cost of treatment did not show a significant difference between the two groups.Conclusions:Future large and prospective studies should explore the severity of disease in older people with dementia and compare results with older adults without dementia in the emergency department.

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