Geriatric trauma: Outcomes of elderly patients discharged from the ED

This study was undertaken to investigate which patients 65 years of age or older have adverse outcomes after discharge from the emergency department ( ED) after an injury, Patients were enrolled prospectively at an urban unive rsity center from September 15, 1996, until August 31, 1997, Patients susta ining any potentially serious form of injury were included. Data about como rbid conditions, preinjury medications, and types of injuries sustained wer e recorded. Patients were contacted at home at least 30 days after discharg e and were questioned about their overall health, need for admission since ED discharge, and whether any complications developed, One hundred five con secutive patients were enrolled, but 5 patients were lost to follow up. The re were 74 low mechanism falls (LMFs), 11 low-mechanism motor vehicle crash es (LMMVCs), 8 high mechanism motor vehicle crashes (HMMVCs), 3 high mechan ism falls (HMFs), and 4 other types of injuries, Follow-up ranged from 30 t o 147 days, with a mean of 49 days. On follow-up, 88 patients were doing we ll, 9 were fair, and 3 were doing poorly; of the latter, their poor health was unrelated to their injuries, Complications included 2 extremity infecti ons and 1 poorly healing wound, Eleven patients were seen in an ED within t he first 30 days after injury, 6 of whom for problems related to their init ial injury or its management These results show that there is a subset of e lderly victims of trauma who may be safely discharged home after appropriat e evaluation. Return visits to the ED were just as often related to comorbi d conditions as to initial injury. (Am J Emerg Med 1999;17:629-632 Copyrigh t (C) 1999 by W.B. Saunders Company).