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Emergency department utilization and risk factors for mortality in older patients: an analysis of Korean National Emergency Department Information System data

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Abstract
Objective With trends in population aging an increasing number of older patients are visiting the emergency department (ED). This study aimed to identify the characteristics of ED utilization and risk factors for in-hospital mortality in older patients who visited EDs. Methods This nationwide observational study used National Emergency Department Information System data collected during a 2-year period from January 2016 to December 2017. The characteristics of older patients aged 70 years or older were compared with those of younger patients aged 20 to 69 years. Risk factors associated with in-hospital mortality were analyzed by multivariable logistic regression. Results A total of 6,596,423 younger patients and 1,737,799 older patients were included. In the medical and nonmedical older patient groups, significantly higher proportions of patients were transferred from another hospital, utilized emergency medical services, had Korean Triage and Acuity Scale scores of 1 and 2, required hospitalization, and required intensive care unit admission in the older patient group than in the younger patient group. ED and post-hospitalization mortality rates increased with age; in particular, older medical patients aged 90 or older had an in-hospital mortality rate of 9%. Older age, male sex, transfer from another hospital, emergency medical service utilization, a high Korean Triage and Acuity Scale score, systolic blood pressure <100 mmHg, respiratory rate >20/min, heart rate >100/min, body temperature <36°C, and altered mental status were associated with in-hospital mortality. Conclusion Development of appropriate decision-making algorithms and treatment protocols for high risk older patients visiting the ED might facilitate appropriate allocation of medical resources to optimize outcomes.
Author(s)
강형구김소윤김수진김원영이성우이희경정진우조용일한갑수
Issued Date
2021
Type
Article
Keyword
AgedEmergency servicehospitalMortalityOriginalRisk factors응급의학
DOI
10.15441/ceem.20.098
URI
https://oak.ulsan.ac.kr/handle/2021.oak/8288
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_nrf_kci_oai_kci_go_kr_ARTI_9825844&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Emergency%20department%20utilization%20and%20risk%20factors%20for%20mortality%20in%20older%20patients:%20an%20analysis%20of%20Korean%20National%20Emergency%20Department%20Information%20System%20data&amp;offset=0&amp;pcAvailability=true
Publisher
Clinical and Experimental Emergency Medicine
Location
미국
Language
영어
ISSN
2383-4625
Citation Volume
8
Citation Number
2
Citation Start Page
128
Citation End Page
136
Appears in Collections:
Medicine > Medicine
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