PATIENTS OLDER THAN 60 YEARS ADMITTED TO AN EMERGENCY WARD - A PROSPECTIVE-STUDY OF 1012 MEDICAL RECORDS

Patients aged 60 years and older who were admitted to the emergency wa rd of the Edouard Herriot Hospital in Lyon were studied prospectively. These patients accounted for 40% of all admissions. Slightly over hal f were women (56%), and mean age was 78 years. Forty per cent lived al one, 83% were sent to the hospital by their physician, and 33% had car diovascular disease. Factors that influenced destination on leaving th e emergency ward were age, degree of dependency, and medical condition s: 78% of patients went to a short-stay medical ward, 16% returned to their home, and 6% died at the hospital. Mean hospital stay duration w as 2.6 days. Factors associated with substantially longer hospital sta y durations were advanced age, psychological dependence, a number of s pecific diagnoses, immediate referral by the emergency room to a mediu m- or long-term care department, and a need for special arrangements t o be made in order that the patient may be discharged home. Aggregatio n of these factors defined a subset of very elderly patients, of whom many had dementia or Parkinson's disease. Long-term care facilities we re unlikely to accept patients from the emergency room (one of 238 req uests accepted).