Study: Risk of Disability is Higher in Older Adults Who Visit the ED

A new study found that emergency department visits were associated with an increased risk for disabilities and functional decline in older adults, as well as more admissions to nursing homes and mortality.

The study included 754 non-disabled older individuals with a mean age of 84 years who completed monthly interviews for 14 years. Researchers compared 813 emergency department visits to 813 similar incidences without emergency department visits during 6-month follow-ups. In addition, researchers compared emergency department visits to unmatched emergency department visits that resulted in hospitalization. Participants' ability to function was assessed using a disability score ranging from 0 (lowest) to 13 (highest).
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The disability scores for participants at the beginning of the study were 3.4 for the emergency department visit group and 3.6 for the non-emergency department visit group.

The results showed that participants who visited emergency department but were not hospitalized had significantly higher disability scores 6 months after the visit than the group that did not go to the emergency room. For participants who went to the emergency department, the adjusted risk ratio was 1.14. Those who were hospitalized after an emergency department visit had significantly higher disability scores than the emergency department only group, with a risk ratio of 1.17.

Overall, the group that visited the emergency room but was not admitted to the hospital had higher nursing home admissions and mortality within the 6-month follow up than participants who did not visit an emergency room.

“Although not as debilitating as an acute hospitalization, illnesses and injuries leading to an ED visit without hospitalization were associated with a clinically meaningful decline in functional status during the following 6 months, suggesting that the period after an ED visit represents a vulnerable time for community-living older persons,” the researchers concluded.

—Melissa Weiss

Reference:

Nagurney JM, Fleischman W, Han L, Leo-Summers L, Allore HG, Gill TM. Emergency department visits without hospitalization are associated with functional decline in older persons [published online January 6, 2017]. Annals of Emergency Medicine. doi:10.1016/j.annemergmed.2016.09.018.