Elderly Non-Specific Complaints Raise Mortality

TOPLINE: Older adults with non-specific complaints visiting the emergency department (ED) are at increased risk of hospital admission and 30-days mortality.

METHODOLOGY:

• This retrospective observational study included 4927 older adults (aged, ≥ 65 years) visiting ED with non-specific complaints (n=525) and specific complaints (dyspnea, n=1343; chest pain, n=1599; abdominal pain, n=1460).
• Fatigue, confusion, generalized weakness and risk of falling were defined as non-specific complaints.
• Primary outcomes were hospital admissions rate and 30-day mortality.

TAKEAWAY:

• The hospital admission rates were significantly higher in patients with dyspnea (79%) and non-specific complaints (70%) vs. those with chest pain (63%) and abdominal pain (61%; P <.001>
• Patients with dyspnea (10%) and non-specific complaints (9%) showed higher mortality rate than those with abdominal pain (5%) and chest pain (2%; P <.001>
• Patients with non-specific complaints (4.7 hours) had longer in-hospital LOS than those with chest pain (4 hours), dyspnea (4.3 hours), and abdominal pain (4.5 hours; P <.001>
• Mean bed-days were significantly higher in patients with non-specific complaints (5.6 days) vs. those with chest pain (3.6 days), dyspnea (5.4 days), and abdominal pain (3.2 days; P <.001>

IN PRACTICE:

“Non-specific complaints in older adults can be difficult to assess for ED staff even though these individuals may be at significant risk for hospital requirements and 30-day mortality,” the authors wrote, adding “ED staff should be more vigilant when an elderly patient presents with non-specific complaints at the ED.”

SOURCE:

This study was conducted by the first author Karin Erwander, Department of Clinical Sciences, Lund University, Lund, Sweden and co-authors, which was published online January 3, 2023, in BMC Geriatrics.

LIMITATIONS:

• The degree of acuity or morbidity cannot be measured in terms other than the number of comorbidities. The study did not evaluate frailty, which is a crucial factor in older adults. Also, trauma was not included as the chief complaint.

DISCLOSURES:

This study was funded by Lund university. The authors declared no competing interests.