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Older patients in the emergency department: a review

Samaras, Nikolaos
Published in Annals of Emergency Medicine. 2010, vol. 56, no. 3, p. 261-269
Abstract Older patients account for up to a quarter of all emergency department (ED) visits. Atypical clinical presentation of illness, a high prevalence of cognitive disorders, and the presence of multiple comorbidities complicate their evaluation and management. Increased frailty, delayed diagnosis, and greater illness severity contribute to a higher risk of adverse outcomes. This article will review the most common conditions encountered in older patients, including delirium, dementia, falls, and polypharmacy, and suggest simple and efficient strategies for their evaluation and management. It will discuss age-related changes in the signs and symptoms of acute coronary events, abdominal pain, and infection, examine the yield of different diagnostic approaches in this population, and list the underlying medical problems present in half of all "social" admission cases. Complete geriatric assessments are time consuming and beyond the scope of most EDs. We propose a strategy based on the targeting of high-risk patients and provide examples of simple and efficient tools that are appropriate for ED use.
Keywords Abdominal Pain/diagnosis/therapyAccidental Falls*Aged/statistics & numerical dataAlcoholism/diagnosis/therapyCoronary Disease/diagnosis/therapyElder Abuse*Emergency Service, Hospital/statistics & numerical dataHumansInfection/diagnosis/therapyMental Disorders/diagnosis/therapyPharmaceutical Preparations/adverse effectsPolypharmacyRisk FactorsSubstance-Related Disorders/diagnosis/therapy
PMID: 20619500
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Research group Démence du sujet âgé, troubles cognitifs, la symptomatologie cognitive (577)
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SAMARAS, Nikolaos et al. Older patients in the emergency department: a review. In: Annals of Emergency Medicine, 2010, vol. 56, n° 3, p. 261-269. https://archive-ouverte.unige.ch/unige:21281

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Deposited on : 2012-05-23

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