Epidemiology of Older Patients Presenting to Irish Emergency Departments: A Subgroup Analysis of the EGERS Dataset
Year: 2024
Type: article
Abstract: Introduction Within Emergency Medicine, older adults represent a distinct population with unique needs and challenges. There is a scarcity of epidemiologic data on the requirements of Ireland’s older population for, and their utilisation of, emergency care networks. We sought to assess this deficit utilising data from the recently published European Geriatric Emergency Departments Registry Study (EGERS) dataset. Methodology A prospective, cohort study of older adult patients (≥65) presenting to Irish Emergency Departments over a 7-day period. The dataset was originally collected as part of the EGERS study. The Irish subpopulation was extracted, analysed in further detail, and compared to the remaining non-Irish population. Data on demographics, presenting complaint, vital signs, chronic medication and co-morbidities were compared. Outcome data including emergency department and hospital length of stay, ICU admission and mortality rate were also assessed. Results A total of 361 Irish patients were identified. Median (IQR) age was 77(71-82) and 193(53.5%) were male. The proportion of patients aged >85 was higher in the non-Irish population (24.0% vs 13.9%, RR 1.13, 95% CI 1.08-1.18). The most common presenting complaints were falls (N=65, 18%), shortness of breath (N=51, 13.5%), chest pain (N=44, 11.7%) and abdominal pain (N=37, 9.8%). Multiple presenting complaints occurred in 69(19.1%) patients. Traumatic presenting complaints occurred in 67(18.6%) with 9(2.5%) patients reporting mixed traumatic and non-traumatic presentations. The median (IQR) number of co-morbidities in the Irish population was 3 (2-5). Co-morbidities were more common in the Irish population (96.1% vs 89.5%, RR 1.07 95% CI 1.05-1.10), with dyslipidaemia, coronary artery disease, heart failure and asthma/COPD being significantly more frequent. Median (IQR) number of regular medications was 4 (2-6) and chronic medication usage was higher in the Irish population (92% vs 84%, RR 1.10, 95% CI 1.06-1.14). Disability and need for support services was high with 96 (27.8%) patients utilising home help services, while 85 (24.6%) reported previous falls. Admission rates were high (N=186, 52.0%), with no differences between populations. There was no mortality difference between the groups. Irish patients were less likely to be admitted to ICU (2.2% vs 8.7%, RR 0.94, 95% CI 0.92-0.97). Conclusions Irish older adults attending emergency departments present in complex manner and demonstrated higher comorbidity than their European counterparts.
Authors: Sean Croughan, Arina Kruis, Kelly Ann Catherine Janssens, Pro Mukerjee, Denys Shchetkovskyy, Áine Mitchell, Mehmet Akif Karamercan, Zerrin Defne Dundar, Anna Slagman, Effie Polyzogopoulou, Sandor Somodi, Andrea Fabbri, Lars Peter Bjornsen, Wilma Beetge, Said Laribi, Rebecca Ann Sealy, Visnja Nesek Adam, Comfort Adedokun, Lucy Gibbons, Pamela O’Brien, Jessica Lynch, Laura Kenny, Conor Deasy, John Ryan, David Menzies, John Cronin, Vijay Narayanan, Nurali Noorani, Waslet Bakhshi, Ahmed Al Rasheed Ahmed, Rosa McNamara
Institutions: Mercy University Hospital, St. Vincent's University Hospital, St Michael’s Hospital, University Hospital Kerry, University Hospital Limerick, Sligo University Hospital, Gazi University, Necmettin Erbakan University, Charité - Universitätsmedizin Berlin, University General Hospital Attikon, University of Debrecen, Azienda Unità Sanitaria Locale Della Romagna, Norwegian University of Science and Technology, Centre Hospitalier Universitaire de Tours, University College Cork, Klinička bolnica "Sveti Duh", Cork University Hospital
Language: English
Subfield: Emergency Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4405678158