Revisit to ED May Indicate Poor Outcomes in Elderly Patients

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Age, male sex, and polypharmacy were among the independent predictors of a 30-day revisit.
Age, male sex, and polypharmacy were among the independent predictors of a 30-day revisit.

HealthDay News — A revisit to the emergency department within 30 days of a previous visit predicted poor outcomes in elderly adults, according to a study published online in the Journal of the American Geriatrics Society.

Jelle de Gelder, MD, from the Leiden University Medical Center in the Netherlands, and colleagues assessed predictors of emergency department revisits and the association between revisits and 90-day functional decline or mortality in 1093 older adults (median age, 79 years) discharged from the emergency departments of one academic and 2 regional Dutch hospitals.

The researchers found that 114 participants (10.4%) had an emergency department revisit within 30 days of discharge. Independent predictors of a 30-day revisit included age (hazard ratio [HR], 0.96), male sex (HR, 1.61), polypharmacy (HR, 2.06), and cognitive impairment (HR, 1.71). To predict a revisit, the area under the receiver operating characteristic curve was 0.65. Individuals with a revisit were at higher risk (odds ratio, 1.99) of functional decline or mortality in propensity-score-matched analysis.

"An early emergency department revisit is a strong new predictor of adverse outcomes in older adults," the authors wrote.

Reference

de Gelder J, Lucke JA, de Groot B, et al. Predictors and outcomes of revisits in older adults discharged from the emergency department [published online February 28, 2018]. J Am Geriatr Soc. doi:10.1111/jgs.15301

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