AGE-RELATED DIFFERENCES IN DIAGNOSES WITHIN THE ELDERLY POPULATION

The most common diagnoses of elderly patients in the emergency departm ent (ED) were compared among three age subgroups: 65 to 74, 75 to 84, and 85 and older. The computerized billing records for patient visits to 10 northern New Jersey hospital EDs for the years 1985 to 1991 were retrospectively analyzed. The most frequently occurring ICD-9-CM code s for elderly patients were compared among the three age subgroups. El derly persons comprised 174,146 (14% of the total) patient visits. The 176,146 patient visits were assigned 259,440 ICD-9-CM codes. The most common ICD-9-CM codes for medical diagnoses included chest pain, card iac dysrhythmias, congestive heart failure, syncope, abdominal pain, a nd dyspnea. Fractures, particularly of the lower limb and upper limb; contusions; open wounds, particularly of the head, neck, and trunk; an d falls were among the most common trauma diagnoses. The proportions i n the three age subgroups of each diagnosis were statistically signifi cantly different, except for cardiac arrest and contusions of the trun k and of multiple sites. The diagnoses with clinically significant hig her relative risks in older age subgroups were atrial fibrillation, co ngestive heart failure, syncope, hypovolemia/dehydration, gastrointest inal hemorrhage, dyspnea, pneumonia, pulmonary edema, cerebrovascular accident , septicemia, urinary tract infection, fractures, and open wo unds of the head, neck, trunk, particularly the scalp, and falls. Clin ically significant lower relative risks were found in older age subgro ups for chest pain, acute myocardial infarction, hypertension, angina, chronic airway obstruction not elsewhere classified, epistaxis, contu sions of the upper limb, and open wounds of the finger. Copyright (C) 1998 by W.B. Saunders Company.