Work

Emergency department attendance stratified by cause and frailty status: A national retrospective cohort study

Year: 2025

Type: article

Abstract: AIM: The aim of this study was to determine whether the causes of emergency department (ED) attendance and clinical outcomes vary by frailty status. METHODS: Using the Nationwide ED Sample, causes of attendance were stratified by Hospital Frailty Risk Score (HFRS). Logistic regression was used to determine adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) of ED and overall mortality. RESULTS: A total of 155 497 048 ED attendances were included, of which 125 809 960 (80.9%) had a low HFRS (<5), 27 205 257 (17.5%) had an intermediate HFRS (5-15), and 2 481 831 (1.6%) had a high HFRS (>15). The most common cause of ED attendance in the high-HFRS group was infectious diseases (43.0%), followed by cardiovascular diseases (CVD) (24.0%) and respiratory diseases (10.2%). For the low-HFRS group, musculoskeletal disease was the most common cause (21.2%), followed by respiratory diseases (20.6%) and gastrointestinal diseases (18.5%). On adjusted analysis, high-HFRS attendances had increased overall mortality (combined ED and in-hospital) across most attendance causes, compared with their low-risk counterparts (P < 0.001). High-HFRS attendances with infectious diseases, CVD, and respiratory diseases had an increased risk of overall mortality, compared with their low-risk counterparts (aOR 23.88, 95% CI 23.42-24.34 for the infectious disease cohort; aOR 2.58, 95% CI 2.55-2.61 for the CVD cohort; and aOR 36.90, 95% CI 36.18-37.62 for the respiratory disease cohort). CONCLUSIONS: Frailty is present in a significant proportion of ED attendances, with the cause varying by frailty status. Frailty is associated with decreased ED and increased overall mortality across most attendance causes. Geriatr Gerontol Int 2025; 25: 1350-1358.

Source: Geriatrics and gerontology international/Geriatrics & gerontology international

DOI: 10.1111/ggi.70153