Older patients in the emergency department: a review.

Abstract:

:Older patients account for up to a quarter of all emergency department (ED) visits. Atypical clinical presentation of illness, a high prevalence of cognitive disorders, and the presence of multiple comorbidities complicate their evaluation and management. Increased frailty, delayed diagnosis, and greater illness severity contribute to a higher risk of adverse outcomes. This article will review the most common conditions encountered in older patients, including delirium, dementia, falls, and polypharmacy, and suggest simple and efficient strategies for their evaluation and management. It will discuss age-related changes in the signs and symptoms of acute coronary events, abdominal pain, and infection, examine the yield of different diagnostic approaches in this population, and list the underlying medical problems present in half of all "social" admission cases. Complete geriatric assessments are time consuming and beyond the scope of most EDs. We propose a strategy based on the targeting of high-risk patients and provide examples of simple and efficient tools that are appropriate for ED use.

journal_name

Ann Emerg Med

authors

Samaras N,Chevalley T,Samaras D,Gold G

doi

10.1016/j.annemergmed.2010.04.015

subject

Has Abstract

pub_date

2010-09-01 00:00:00

pages

261-9

issue

3

eissn

0196-0644

issn

1097-6760

pii

S0196-0644(10)00385-9

journal_volume

56

pub_type

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