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Friščić M, Zlatar GŠ, Kovaček V, Važanić D, Ivanišević K, Kurtović B. Elderly patients presenting to a rural hospital emergency department in inland Croatia - A retrospective study. Int Emerg Nurs 2021; 58:101035. [PMID: 34332452 DOI: 10.1016/j.ienj.2021.101035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 05/23/2021] [Accepted: 05/28/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Emergency departments are faced with a high influx of patients presenting for various complaints. The aim of the present study was to assess the basic characteristics of elderly patients presenting to a rural hospital emergency department in inland Croatia in 2017. METHODS Retrospective data collected from the Hospital Information System and by analysis of medical records on patients presenting to emergency department in 2017 were used in the study. RESULTS Study results indicated that a lower proportion of elderly individuals aged 65-74 were hospitalized following emergency department workup. A statistically significantly higher proportion of patients older than 74 years was presented to ED due to various discomforts and diseases (ICD-10 group I; χ2 = 324.85; p < 0.01) than due to cardiorespiratory diseases and acute abdomen (χ2 = 285.04; p < 0.01). CONCLUSION Our findings highlight the need for a complex approach in care for elderly people, given that they are a fragile population with multiple comorbidities, chronic diseases, atypical symptoms, and often with cognitive and functional impairments.
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Affiliation(s)
- Marina Friščić
- Dr Tomislav Bardek General Hospital, Željka Selingera 1, HR-48000 Koprivnica, Croatia; Bjelovar University of Applied Sciences, Trg Eugena Kvaternika 4, HR-43000 Bjelovar, Croatia
| | - Gordana Šantek Zlatar
- Dr Tomislav Bardek General Hospital, Željka Selingera 1, HR-48000 Koprivnica, Croatia; Bjelovar University of Applied Sciences, Trg Eugena Kvaternika 4, HR-43000 Bjelovar, Croatia
| | - Valentina Kovaček
- Dr Tomislav Bardek General Hospital, Željka Selingera 1, HR-48000 Koprivnica, Croatia
| | - Damir Važanić
- Croatian Institute of Emergency Medicine, Planinska 13/1, HR-10000 Zagreb, Croatia; Croatian Catholic University, Department of Nursery, Ilica 242, HR-10000 Zagreb, Croatia; Zagreb University of Applied Sciences, Mlinarska cesta 38, HR-10000 Zagreb, Croatia.
| | - Kata Ivanišević
- University of Rijeka, Faculty of Health Studies, Viktora Cara Emina 5, HR-51000 Rijeka, Croatia
| | - Biljana Kurtović
- Zagreb University of Applied Sciences, Mlinarska cesta 38, HR-10000 Zagreb, Croatia.
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Wang J, Han F, Zhao Q, Xia B, Dai J, Wang Q, Le C, Huang S, Li Z, Liu J, Yang M, Wan C, Wang J. Clinicopathological Characteristics of Traumatic Head Injury in Juvenile, Middle-Aged and Elderly Individuals. Med Sci Monit 2018; 24:3256-3264. [PMID: 29773781 PMCID: PMC5987611 DOI: 10.12659/msm.908728] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 03/01/2018] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Traumatic head injury is a leading cause of death and disability worldwide. How clinicopathological features differ by age remains unclear. This epidemiological study analyzed the clinicopathological features of patients with head injury belonging to 3 age groups. MATERIAL AND METHODS Data of patients with traumatic head injury were obtained from the Department of Cerebral Surgery of the Affiliated Hospital of Guizhou Medical University and the Guizhou Provincial People's Hospital in 2011-2015. Their clinicopathological parameters were assessed. The patients were divided into 3 age groups: elderly (≥65 years), middle-aged (18-64 years), and juvenile (≤17 years) individuals. RESULTS Among 3356 hospitalizations for traumatic head injury (2573 males and 783 females, 654 died (19.49%), the highest and lowest mortality rates were in the elderly and juvenile groups, respectively. Fall was the most common cause in juvenile and elderly individuals (32.79% and 43.95%, respectively), while traffic injury was most common in the elderly group (35.08%). The manners of injury differed considerably among the 3 age groups. Scalp injury, skull fracture, intracranial hematoma, and cerebral injury were the most common mechanisms in juvenile (67.32%), middle-aged (63.50%), elderly (69.56%) and middle-aged (90.44%) individuals, respectively. Scalp injury and skull fracture types differed among the groups. Epidural, subdural, and intracerebral hematomas were most common in juvenile, middle-aged, and elderly individuals, respectively. Cerebral contusion showed the highest frequency in the 3 groups, and concussion the lowest. CONCLUSIONS Patients with traumatic HI show remarkable differences in clinicopathological features among juvenile, middle-aged, and elderly individuals.
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Affiliation(s)
- Jiawen Wang
- Department of Forensic Medicine, Guizhou Medical University, Guizhou, Guiyang, P.R. China
| | - Feng Han
- Department of Neurosurgery, Affiliated Hospital of Guizhou Medical University, Guizhou, Guiyang, P.R. China
| | - Qian Zhao
- Department of Neurosurgery, Guizhou Provincial People’s Hospital, Guizhou, Guiyang, P.R. China
| | - Bin Xia
- Department of Forensic Medicine, Guizhou Medical University, Guizhou, Guiyang, P.R. China
| | - Jialin Dai
- Department of Forensic Medicine, Guizhou Medical University, Guizhou, Guiyang, P.R. China
| | - Qian Wang
- Department of Forensic Medicine, Guizhou Medical University, Guizhou, Guiyang, P.R. China
| | - Cuiyun Le
- Department of Forensic Medicine, Guizhou Medical University, Guizhou, Guiyang, P.R. China
| | - Shimei Huang
- Department of Forensic Medicine, Guizhou Medical University, Guizhou, Guiyang, P.R. China
| | - Zhu Li
- Department of Forensic Medicine, Guizhou Medical University, Guizhou, Guiyang, P.R. China
| | - Jiangjin Liu
- Department of Forensic Medicine, Guizhou Medical University, Guizhou, Guiyang, P.R. China
| | - Ming Yang
- Department of Neurosurgery, Affiliated Hospital of Guizhou Medical University, Guizhou, Guiyang, P.R. China
| | - Changwu Wan
- Department of Forensic Medicine, Guizhou Medical University, Guizhou, Guiyang, P.R. China
| | - Jie Wang
- Department of Forensic Medicine, Guizhou Medical University, Guizhou, Guiyang, P.R. China
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Fry M, Fitzpatrick L, Considine J, Shaban RZ, Curtis K. Emergency department utilisation among older people with acute and/or chronic conditions: A multi-centre retrospective study. Int Emerg Nurs 2016; 37:39-43. [PMID: 27743877 DOI: 10.1016/j.ienj.2016.09.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 09/11/2016] [Accepted: 09/14/2016] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Older persons aged over 65years represent up to 41% of Australian Emergency Department (ED) presentations. Older persons present with acute and/or chronic conditions, have more Emergency Department visits, hospital admissions and readmissions than other age groups. However, little is known about the characteristics and trends of acute illness and chronic presentations and whether frailty changes these dimensions within this cohort. METHODS A 12-month retrospective medical record audit of persons over 65years presenting to four EDs. RESULTS Data from 44,774 (26.6%) patients aged 65years and over were analysed. Patients with acute conditions presented more frequently (n=30,373; 67.8%), received more urgent triage categories (n=13,471; 30.1%) and had higher admission rates (n=18,332; 61%). Chronic conditions presented less frequently (n=14,396; 32.1%) and had higher discharge rates (n=9302; 65%). Patients over 80years were allocated more urgent triage categories and commonly presented with falls (n=3814; 8.5%). Patients between 65 and79years had a higher discharge rate (n=10,397; 46.1%). CONCLUSION Older persons with acute illnesses were more likely to be admitted than those with chronic conditions and who were more likely to be discharged home. There is scope for further investigation of new models of care to better manage older persons with chronic conditions and ED discharge practices.
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Affiliation(s)
- Margaret Fry
- Northern Sydney Local Health District, Faculty of Health, University of Technology Sydney, Australia.
| | - Lesley Fitzpatrick
- Emergency Department, Royal North Shore Hospital, Northern Sydney Local Health District, Honorary Associate, Faculty of Health, University of Technology Sydney, Australia.
| | - Julie Considine
- Deakin University, School of Nursing, Geelong, Victoria, Australia; Centre for Quality and Patient Safety Research, 221 Burwood Highway, Burwood, Victoria 3125, Australia; Eastern Health - Deakin University Nursing & Midwifery Research Centre, Level 2, 5 Arnold St, Box Hill, Victoria 3138, Australia.
| | - Ramon Z Shaban
- Menzies Health Institute Queensland, School of Nursing and Midwifery Griffith University, Nathan Campus, N48 Health Sciences Building, 170 Kessels Rd, Nathan, Qld 4111, Australia; Department of Infection Control and Infectious Diseases, Gold Coast University Hospital, Gold Coast Hospital and Health Service, 1 Hospital Blvd, Southport, Qld 4215, Australia.
| | - Kate Curtis
- Sydney Nursing School, University of Sydney, 88 Mallet St, Camperdown, NSW, Australia; Trauma Service, St George Hospital, Gray St, Kogarah, NSW, Australia; St George Clinical School, Faculty of Medicine, University of NSW, NSW, Australia.
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Fry M, Chenoweth L, MacGregor C, Arendts G. Emergency nurses perceptions of the role of family/carers in caring for cognitively impaired older persons in pain: A descriptive qualitative study. Int J Nurs Stud 2015; 52:1323-31. [DOI: 10.1016/j.ijnurstu.2015.04.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 04/20/2015] [Accepted: 04/21/2015] [Indexed: 11/27/2022]
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