Emergency department admission and outcomes in geriatric patients: a single-center prospective cohort study

Geriatric patients often present with nonspecific complaints (NSC). In other words, it is a lack of a specific complaint in a patient presenting with generalized decline and weakness, and an acute serious condition is present in 51-59% of such patients and the list of differential diagnoses is extensive, making epidemiologic studies that address this population of paramount importance. This study aims to identify diagnoses and analyze outcomes in a geriatric population in a Brazilian ED. This is a single-center, prospective cohort study from March to December 2019. This study examined epidemiology, care and outcomes for all older people (> 65 years) who were sufficiently medically ill to require hospital admission after their index ED presentation. We enrolled 237 patients during the study period. The mean age was 74.9 with a standard deviation of 7.7. The majority with 58.3% was male. Their main comorbidities include stroke – 15.2%, previous myocardial infarction – 14.8% and cancer – 5.9%. The cohort has a mean score of 2.5 on the activities of daily living (ADL) scale and 45% are classified as fragile, 44% as pre-fragile and only the remaining 11% are not fragile. Patients went on to surgery in 22.3% of cases, were admitted to the ICU in 28.1%, were intubated in 22.2% and died in 14.1% of the cases. All elderly patients who present to the emergency department have comorbidities and most are frail or pre-frail. Frail patients and those with impairment of activities of daily living have higher mortality rates.