Early revisit, hospitalization, or death among older persons discharged from the ED

The purpose of this study to determine predictors of revisit, hospital admi ssion, or death among older patients discharged from the emergency departme nt (ED), We performed a prospective study of patients aged 65 or older in a n urban ED. The primary outcomes were ED revisit, hospital admission, or de ath 30 or 90 days after discharge from an index ED visit. Of the 463 eligib le patients, 75 (16%) experienced ED revisit, hospitalization, or death wit hin 30 days, and 125 (27%) within 90 days. In multivariate proportional haz ards models, physical functioning and mental health in the lowest tertile, and lack of supplemental insurance predicted revisit, hospitalization, or d eath within 30 days after ED discharge. Poor physical functioning, missing mini-mental state examination, co-morbidity, and ambulance transport to the initial ED visit predicted 90-day outcome. Problems with physical function ing, mental health and supplemental insurance are potentially remediable pr ecursors of early morbidity among older patients after ED discharge. Future research should examine whether addressing these issues among the elderly population will lessen ED return visits, hospitalization, and mortality. (C opyright (C) 2001 by W.B. Saunders Company).