Differences in management between young and elderly patients in the emergency department

Abstract

Objectives: To compare the demographic and clinical characteristics of young and elderly patients in the emergency department.

Materials and Methods: In this prospective, cross-sectional study all patients who were admitted to emergency department (ED) during a one-month period were dichotomized into two age groups: young (between 1764 years old) and elderly (over 64 years old). Data were collected using a standard form developed for this study.

Results: There were 2.105 (78%) patients in the young group and 600 (22%) patients in elderly group. In elderly group, frequency of ED visits during the six months preceding their current visit, need of monitoring, rate of consultation orders, rate of admission to hospital and length of stay in the ED were statistically higher than the young group. (37% vs. 26%, p=0.000; 41% vs. 15%, p=0.000; 41% vs. 21%, p=0,000, 18% vs. 6%, p=0.000; and 8 hours vs. 3 hours, p=0.000, respectively). In the elderly group; blood glucose, complete blood count, renal function tests and electrolytes, cardiac markers and electrocardiography were ordered more frequently than the young group. (mean, 1.87 vs. 1.26, p=0.000; 1.24 vs. 1.11, p=0.024; 1.20 vs. 1.06, p=0.013; 1.68 vs. 1.55, p=0.013 and 3.84 vs. 2.85, p=0.000, respectively). There were no statistically significant differences in the number of orders for radiological studies between two groups. The most common presenting complaint was gastrointestinal disorders in both groups. The most common final diagnosis was cardiovascular disorders in elderly population compared to non-specific symptomatic disorders in the young group (p=0.000, p=0.000, respectively).

Conclusion: There might be some differences according to unique characteristics of both patients and hospital during the management of geriatric patients in the emergency department. Each hospital should determine their specific requirements either for itself or for the patients and coordinate the emergency health care service according these settings.