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. 2025 Jan;20(1):247-256.
doi: 10.1007/s11739-024-03638-z. Epub 2024 Jun 19.

Use of resources in elderly patients consulting the emergency department: analysis of the Emergency Department and Elder Needs Cohort (EDEN-21)

Elena Fuentes  1 , Javier Jacob  2 , Juan González Del Castillo  3 , Francisco Javier Montero-Pérez  4 , Aitor Alquezar-Arbé  5 , Eric Jorge García-Lamberechts  3 , Sira Aguiló  6 , Cesáreo Fernández-Alonso  3 , Guillermo Burillo-Putze  7 , Pascual Piñera  8 , Lluís Llauger  9 , Verónica Vázquez-Rey  10 , Elena Carrasco-Fernández  11 , Ricardo Juárez  12 , María José Blanco-Hoffman  13 , Eva de Las Nieves Rodríguez  14 , Rafaela Rios-Gallardo  15 , María Amparo Berenguer-Diez  16 , Sandra Guiu  17 , Nieves López-Laguna  18 , Violeta Delgado-Sardina  19 , Francisco Javier Diego-Robledo  20 , Patxi Ezponda  21 , Andrea Martínez-Lorenzo  22 , Juan Vicente Ortega-Liarte  23 , Inmaculada García-Rupérez  24 , Setefilla Borne-Jerez  25 , Adriana Gil-Rodrigo  26 , Pere Llorens  26 , Òscar Miró  6 ; EDEN Research Group
Collaborators, Affiliations

Use of resources in elderly patients consulting the emergency department: analysis of the Emergency Department and Elder Needs Cohort (EDEN-21)

Elena Fuentes et al. Intern Emerg Med. 2025 Jan.

Abstract

The elderly population frequently consults the emergency department (ED). This population could have greater use of EDs and hospital health resources. The EDEN cohort of patients aged 65 years or older visiting the ED allowed this association to be investigated. To analyse the association between healthcare resource use and the characteristics of patients over 65 years of age who consult hospital EDs. We performed an analysis of the EDEN cohort, a retrospective, analytical, and multipurpose registry that includes patients over 65 years of age who consulted in 52 Spanish EDs. The impact of age, sex, and characteristics of ageing on the following outcomes was studied: need for hospital admission (primary outcome) and need for observation, stay in the ED > 12 h, prolonged hospital stay > 7 days, need for intensive care unit (ICU) and return to the ED at 30 days related to the index visit (secondary outcomes). The association was analysed by calculating the adjusted odds ratios (aOR) and their 95% confidence intervals (CI), using a logistic regression model. A total of 25,557 patients with a mean age of 78.3 years were analysed, 45% were males. Of note was the presence of comorbidity, a Charlson index ≥ 3 (33%), and polypharmacy (66%). Observation in the ED was required by 26%, 25.4% were admitted to the hospital, and 0.9% were admitted to the ICU. The ED stay was > 12 h in 12.5% and hospital stay > 7 days in 13.5% of cases. There was a progressive increase in healthcare resource use based on age, with an aOR for the need for observation of 2.189 (95% CI 2.038-2.352), ED stay > 12 h 2.136 (95% CI 1.942-2.349) and hospital admission 2.579 (95% CI 2.399-2.772) in the group ≥ 85 years old. Most of the characteristics inherent to ageing (cognitive impairment, falls in the previous 6 months, polypharmacy, functional dependence, and comorbidity) were associated with significant increases in the use of healthcare resources, except for ICU admission, which was less in all the variables studied. Age and the characteristics inherent to ageing are associated with greater use of structural healthcare resources.

Keywords: Care Resources; Elderly; Emergency Department; Management.

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Conflict of interest statement

Declarations. Conflict of interest: The authors declare that they have no conflict of interest. Data availability statement: All data supporting the findings of this study are available within the paper. Ethical statements: The EDEN Project was approved by the Ethical Committee of Clinical Investigation of the Hospital Clínico San Carlos de Madrid (protocol HCSC/22/005-E). Human and animal rights and informed consent statement: Written informed consent on behalf of the patients was waived due to the study characteristics. The use of a database in which the patients were codified was used to maintain anonymity. The ethical principles of the Declaration of Helsinki were followed at all times.

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