Screening of community-dwelling older patients by the emergency medical services: An observational retrospective registry study

Abstract

Background: Inadequate nutrition, falls, and cognitive impairment are common problems among acutely ill older people and are associated with complicated and prolonged health problems and mortality.

Objectives: To assess if the emergency medical services can identify patients with nutritional risk, falls risk, and cognitive impairment by using simple screening tools and to assess the prevalence of risks and rate they are reported to the emergency department.

Setting: The study was carried out in Espoo, Finland to patients over the age of 70 requiring non-urgent ambulance transfer to the emergency department.

Outcome measures: A set of validated electronic screening tools was used to identify patients at nutritional risk, risk of falling and having cognitive impairment.

Main results: A total of 488 (8%) out of 5792 patients were screened. Of the patients 60%, (n = 292) had at least one risk: 17% (n = 81) had nutritional risk, 43% (n = 209) falls risk, and 28% (n = 137) cognitive impairment. Twenty-two (5%) were screened positive in all three categories. The observed risk was reported to the emergency department staff in 59% (n = 173) of the patients.

Conclusion: The emergency medical services can be used in preventive health care to identify patients having nutritional risk, falls risk, or cognitive impairment.

Keywords: Cognitive impairment; Emergency medicine; Falls risk; Nutritional risk; Risk assessment.