Elderly use of the ED in an Asian metropolis

To compare emergency department (ED) use by elderly patients (age 65 yrs or older) with that by younger adult patients (age 15-64 yrs), a prospective consecutive chart review study was conducted from August 1, 1995 through Ma y 31, 1996 in eight designated hospitals in Taipei city (which has 2.6 mill ion residents, 8.4% of whom are 65 yrs or older). Patient age, sex, mode of arrival, living status, triage category, advanced life support (ALS) eligi bility referral, confinement to bed, intensive care unit (ICU) admission, i mpression, trauma mechanism, and disposition were recorded and compared bet ween the two groups. Of 27,765 adult emergency patients studied during the 10 months, 24% were elderly. The elderly were more likely to be ambulance c ases, of high acuity and ALS eligibility, living alone, bed ridden, and ICU cases (19.4% v 10.5%,14.8% v 5.5%, 14.7% v 4.3%, 9.7% v 4.1%, 16% v 1.1%, and 4.0 v 1.1%, respectively). The three leading illnesses in the elderly w ere cerebral vascular accident (6.6%), cancer (5.6%), and cardiovascular di sease (5.6%), and the two most common trauma mechanisms were trip (fall fro m the same lever surface) (57.2%) and traffic accident (20.7%). Twenty-seve n percent and 22.7% of elderly were disposed to admission and observation, respectively, compared with the 10.9% and 11.4% of the younger patients. El derly patients have significantly different and more severe presentations t o the ED compared with younger adults. Copyright (C) 1999 by W.B. Saunders Company.