Investigation of the relationship between emergency department applications and prognoses of geriatric patients

Ş. Savrun, A. Savrun
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Abstract

The World Health Organization (WHO) stated that the elderly population constituted 12% of the population of people over 60 years old in 2015. In the coming years, by 2030, 1 out of 6 people in the world will be 60 years or older, and this ratio will increase to 22% in 2050. In addition, it is estimated that the proportion of the elderly population will be 11.0% in 2025, 12.9% in 2030, 16.3% in 2040, 22.6% in 2060 and 25.6% in 2080. The number of admissions to the emergency services of geriatric patients, the hospital treatment process, and even the mortality and morbidity rates increase in elderly patients. In this direction, it was aimed to retrospectively analyze the data of patients over 65 who applied to a tertiary hospital emergency department and determine the factors affecting the mortality of geriatric patients. The presented study is a cross-sectional and retrospective study. All patients over the age of 65 who applied to the emergency department of Ordu University Medical Faculty Training and Research Hospital between 01 July 2022 and 31 2022 were retrospectively analyzed. Demographic features of the cases, the way they applied to the emergency room (112 Emergency Service Ambulance, others: with their own vehicle, by taxi, etc.), the last diagnosis in the emergency department (neurological, cardiovascular, respiratory, metabolic, trauma and others), treatment methods (outpatient, inpatient, intensive care), their motility and the relationship of these data with each other were examined. Between the specified dates, a total of 28459 patients over the age of 18 were admitted to the emergency department. It was determined that 10.16% (n=2894) of these patients consisted of patients over 65 years of age. The relationship between the treatment modalities and mortality according to the way the patients came to the hospital was found to be statistically significant (p<0.005). The relationship between hospitalization, treatment modalities and mortality was statistically significant according to the clinical diagnosis of the cases (p<0.005). In the presented study, it was determined that the mortality of patients who applied to the emergency department due to metabolic problems and who used the ambulance system as a referral tool was high. In fact, the prognosis of geriatric patients who apply to the emergency department for any reason, especially by using the emergency ambulance system, is worse than those who do not use the emergency ambulance system. For this reason, the use of an emergency ambulance system alone affects the prognosis negatively and it is necessary to evaluate such geriatric patients more carefully.
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急诊科应用与老年患者预后关系的研究
世界卫生组织(世卫组织)指出,2015年,老年人口占60岁以上人口的12%。未来几年,到2030年,世界上每6个人中就有1个人年龄在60岁或以上,到2050年这一比例将增加到22%。此外,预计2025年老年人口比例为11.0%,2030年为12.9%,2040年为16.3%,2060年为22.6%,2080年为25.6%。急诊科老年患者的入院人数、住院治疗过程,甚至老年患者的死亡率和发病率都在增加。在此方向上,本研究旨在回顾性分析某三级医院急诊科65岁以上患者的资料,确定影响老年患者死亡率的因素。本研究为横断面及回顾性研究。回顾性分析2022年7月1日至2022年7月31日期间在奥尔杜大学医学院培训与研究医院急诊科就诊的所有65岁以上患者。研究了病例的人口学特征、应用于急诊室的方式(112急救救护车,其他:使用自己的车辆,乘坐出租车等)、在急诊科的最后诊断(神经、心血管、呼吸、代谢、创伤等)、治疗方法(门诊、住院、重症监护)、患者的运动以及这些数据之间的关系。在指定日期之间,共有28459名18岁以上的患者入住急诊科。确定10.16% (n=2894)的患者年龄在65岁以上。患者就诊方式与死亡率的关系有统计学意义(p<0.005)。根据病例的临床诊断,住院、治疗方式与死亡率之间的关系有统计学意义(p<0.005)。在本研究中,确定了因代谢问题而申请急诊科并使用救护车系统作为转诊工具的患者的死亡率很高。事实上,以任何理由申请急诊科的老年患者,特别是使用紧急救护系统的患者,其预后比不使用紧急救护系统的患者更差。因此,单独使用紧急救护系统会对预后产生负面影响,有必要更仔细地评估此类老年患者。
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