scholarly journals Can consultant geriatrician led comprehensive geriatric assessment in the emergency department reduce hospital admission rates? A systematic review

2016 ◽  
Author(s):  
Samuel Jay ◽  
Paula Whittaker ◽  
Jerome Mcintosh ◽  
Nicholas Hadden
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Hospital Admission ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Admission Rates

scholarly journals Comprehensive Geriatric Assessment and Clinical Outcomes in the Older People at the Emergency Department

2021 ◽  
Vol 18 (11) ◽  
pp. 6164
Author(s):  
Cheng-Fu Lin ◽  
Po-Chen Lin ◽  
Sung-Yuan Hu ◽  
Yu-Tse Tsan ◽  
Wei-Kai Liao ◽  
...  
Keyword(s):  
Emergency Department ◽  
Older People ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Multivariate Regression ◽  
Multivariate Regression Analysis ◽  
Intervention Period ◽  
Frailty Phenotype ◽  
Admission Rates

Visits by older people to the Emergency Department (ED) have increased in recent decades with higher revisiting and admission rates after discharge, particularly for those with frailties. This study used a before–after design aimed at evaluating Comprehensive Geriatric Assessment (CGA) screening in older ED patients (aged ≥75 years) during the 12-month preintervention period. Additionally, a CGA-based structured follow-up program after ED discharge was executed during the next 12-month intervention period. Amongst the 358 participants (median age 82 years), involving 122 in the preintervention period and 236 in the intervention period, 77 participants (21.5%) were identified as pre-frailty, while 274 (76.5%) were identified as frail using the Fried frailty phenotype. One-hundred ten (110) (30.7%) patients revisited the ED with 73 (20.4%) being admitted and 20 (5.6%) dying within three months after ED discharge. Compared with preintervention and intervention period, it was shown that the rates of admission at the index ED visit (50.8% vs. 23.1%), and mortality (10.7% vs. 3.0%), were both were significantly reduced. Using multivariate regression analysis, it was shown frailty was significantly associated with three-month mortality after adjusting for potential confounders. On the contrary, the program significantly decreased admission and death rate. It is suggested that frailty was prevalent amongst the older ED patients, and should be screened for in order to decrease revisits/admissions after ED discharge.

scholarly journals 185 Revisiting Comprehensive Geriatric Assessment in the Emergency Department

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Lucinda Edge ◽  
Brian O'Rourke ◽  
Conal Cunningham ◽  
Frances Horgan
Keyword(s):  
Emergency Department ◽  
Hospital Admission ◽  
Grip Strength ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Interdisciplinary Team ◽  
Community Services ◽  
Functional Mobility ◽  
Calf Circumference ◽  
The Past

Abstract Background In a large teaching hospital, a specialist interdisciplinary team identify frailty and begin comprehensive geriatric assessment of older adults in the Emergency Department (ED). This study aimed to determine the clinical utility of a range of measures: grip strength, calf circumference, frailty and functional mobility to evaluate whether they help to estimate the care pathways for patients. Objectives included: (1) To ascertain the prevalence of frailty and (2) To profile this population’s demographics, falls history, calf circumference and grip strength. Methods This was a cross-sectional study. Inclusion criteria were persons ≥ 70 who presented to ED weekdays during research hours 9:00 – 16:00, with Manchester triage score ≥ 3. Information on gait aids, social supports and falls in the past 6 months was self-reported. Grip strength was assessed using hydraulic hand-held dynamometry. Sarcopenia was measured using calf circumference as a proxy. Frailty was determined using the Clinical Frailty Scale (CFS). Functional mobility was assessed by an interdisciplinary team member. Onward referrals and admission to hospital were recorded. Data was analysed using SPSS statistics software. Results One hundred and one participants were included, 39 male (38.6%) and 62 female (61.4%), mean age 79.3 years. Thirty-five percent (n=36) were considered Frail (a CFS score of ≥5), 35.6% (n=36) lived alone, 52.5% (n=53) used a gait aid. Outcomes included admission to hospital (27.7%, n=28) and discharge with onward referral (25.7%, n=26). The most common referral was community physiotherapy (11.9%, n=12). The population identified as frail were more likely to be female (p = 0.036), to use a gait aid (p = 0.001) and to have fallen within the past 6 months (p = 0.007). Conclusion The prevalence of frailty was determined in this population and was not significantly associated with hospital admission, grip strength or calf circumference. A focus on alternative pathways to hospital admission with appropriate access to community services is recommended for individuals with frailty.

scholarly journals Efficiency and applicability of comprehensive geriatric assessment in the Emergency Department: a systematic review

2011 ◽  
Vol 23 (4) ◽  
pp. 244-254 ◽  
Author(s):  
Christophe E. Graf ◽  
Dina Zekry ◽  
Sandra Giannelli ◽  
Jean-Pierre Michel ◽  
Thierry Chevalley
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment

The Most Dangerous Game: A Review of Head and Neck Injuries in American Football and Rugby

2022 ◽  
pp. 194338752110734
Author(s):  
Jordan Richardson ◽  
Dani Stanbouly ◽  
Harrison Moynihan ◽  
Renée M. Reynolds ◽  
Matthew J. Recker ◽  
...  
Keyword(s):  
Emergency Department ◽  
Hospital Admission ◽  
Head And Neck ◽  
Predictor Variable ◽  
American Football ◽  
Outcome Variable ◽  
Neck Injuries ◽  
Injury Surveillance System ◽  
Admission Rates ◽  
Increased Risk

Study Design The investigators designed and implemented a 20-year cross-sectional study using the National Electronic Injury Surveillance System database. Objective The purpose of this study is to estimate and compare hospital admission (danger) rates between rugby and football of those who presented to the emergency department with head and neck injuries after playing these sports. Methods The primary predictor variable was sport played. The primary outcome variable was danger, measured by hospital admission rates. Results Over the past 20 years, there has been a trend of decreasing incidence of injuries presenting to the emergency department in both sports. There was no difference in the rate of hospital admission when comparing football and rugby (OR, 1.2; P = .1). Male gender was associated with an increased risk of admission. Other variables associated with hospital admission included white racial group, injury taking place in the fall, being either young (15–24 years old) or senior (65 years of age and over), and being injured at school or at a sport/recreational facility. Conclusions There is no difference in danger as measured by admission rates between American football and rugby. There exists, however, several variables that are associated with admission when sustaining injury to the head and neck, when playing these two sports.

Patients in need of comprehensive geriatric assessment: The utility of the InterRAI emergency department screener

2021 ◽  
Vol 54 ◽  
pp. 100943
Author(s):  
Elfa Gretarsdottir ◽  
Anna Björg Jonsdottir ◽  
Ingibjörg Sigurthorsdottir ◽  
Ester Eir Gudmundsdottir ◽  
Ingibjörg Hjaltadottir ◽  
...  
Keyword(s):  
Emergency Department ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment
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