Epidemiology and outcome of older patients presenting with dyspnoea to emergency departments.

Abstract:

OBJECTIVES:To describe the epidemiology and outcomes of non-traumatic dyspnoea in patients aged 75 years or older presenting to emergency departments (EDs) in the Asia-Pacific region. METHODS:A substudy of a prospective interrupted time series cohort study conducted at three time points in EDs in Australia, New Zealand, Singapore, Hong Kong and Malaysia of patients presenting to the ED with dyspnoea as a main symptom. Data were collected over three 72-h periods and included demographics, co-morbidities, mode of arrival, usual medications, ED investigations and treatment, ED diagnosis and disposition, and outcome. The primary outcomes of interest are the epidemiology and outcome of patients aged 75 years or older presenting to the ED with dyspnoea. RESULTS:1097 patients were included. Older patients with dyspnoea made up 1.8% [95% confidence interval (CI) 1.7-1.9%] of ED presentations. The most common diagnoses were heart failure (25.3%), lower respiratory tract infection (25.2%) and chronic obstructive pulmonary disease (17.6%). Hospital ward admission was required for 82.6% (95% CI 80.2-84.7%), with 2.5% (95% CI 1.7-3.6%) requiring intensive care unit (ICU) admission. In-hospital mortality was 7.9% (95% CI 6.3-9.7%). Median length of stay was 5 days (interquartile range 2-8 days). CONCLUSION:Older patients with dyspnoea make up a significant proportion of ED case load, and have a high admission rate and significant mortality. Exacerbations or worsening of pre-existing chronic disease account for a large proportion of cases which may be amenable to improved chronic disease management.

journal_name

Age Ageing

journal_title

Age and ageing

authors

Kelly AM,Keijzers G,Klim S,Craig S,Kuan WS,Holdgate A,Graham CA,Jones P,Laribi S

doi

10.1093/ageing/afaa121

subject

Has Abstract

pub_date

2021-01-08 00:00:00

pages

252-257

issue

1

eissn

0002-0729

issn

1468-2834

pii

5913315

journal_volume

50

pub_type

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