Abstract Background Nursing home residents (NHRs) are a medically complex and vulnerable population. Despite often presenting to emergency departments (EDs) with seemingly straightforward complaints, their underlying health issues frequently reveal significant medical, psychological, and social complexities. This underscores the need for comprehensive and specialised geriatric care. Methods This retrospective study examined hospital admissions of NHRs over a six-month period (June–December 2024) at a University Teaching Hospital. Key variables included admission diagnoses, Charlson Comorbidity Index (CCI) scores, and mortality outcomes. Results Of 312 NHRs who presented to the ED, 63.8% (n=199) were admitted. Among these, 68.3% (n=136) were admitted under geriatric services, while 31.7% (n=63) were managed by other specialties. Overall, 88% (n=175) of admitted residents had a CCI score ≥5, indicating high medical complexity. This figure rose to 91% among those under geriatric care, compared to 84% in other services. The average length of stay was 8 days. Upon discharge, 80% (n=109) had two or more diagnoses, and 25% had four or more. Common discharge diagnoses included lower respiratory tract infections (n=56), falls (n=36), acute kidney injury (n=33), urinary tract infections (n=30), aspiration pneumonia (n=29), and constipation (n=20). The in-hospital mortality rate was 8.8% (n=12), with a three-month post-discharge mortality rate of 15% (n=19). Dementia was present in 47% of admitted residents, and 9% had mild cognitive impairment. Delirium occurred in 25% of cases. Conclusion Nursing home residents admitted to hospital present with high levels of medical complexity and multiple co-morbidities, contributing to significant morbidity and mortality. These findings highlight the urgent need for enhanced, multidisciplinary acute geriatric care models to better address the complex needs of this population and improve clinical outcomes.
Noonan et al. (Mon,) studied this question.