Document Detail


Older patients in the emergency department: a review.
MedLine Citation:
PMID:  20619500     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Older patients account for up to a quarter of all emergency department (ED) visits. Atypical clinical presentation of illness, a high prevalence of cognitive disorders, and the presence of multiple comorbidities complicate their evaluation and management. Increased frailty, delayed diagnosis, and greater illness severity contribute to a higher risk of adverse outcomes. This article will review the most common conditions encountered in older patients, including delirium, dementia, falls, and polypharmacy, and suggest simple and efficient strategies for their evaluation and management. It will discuss age-related changes in the signs and symptoms of acute coronary events, abdominal pain, and infection, examine the yield of different diagnostic approaches in this population, and list the underlying medical problems present in half of all "social" admission cases. Complete geriatric assessments are time consuming and beyond the scope of most EDs. We propose a strategy based on the targeting of high-risk patients and provide examples of simple and efficient tools that are appropriate for ED use.
Authors:
Nikolaos Samaras; Thierry Chevalley; Dimitrios Samaras; Gabriel Gold
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Annals of emergency medicine     Volume:  56     ISSN:  1097-6760     ISO Abbreviation:  Ann Emerg Med     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-23     Completed Date:  2010-09-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8002646     Medline TA:  Ann Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  261-9     Citation Subset:  AIM; IM    
Copyright Information:
Copyright (c) 2010 American College of Emergency Physicians. Published by Mosby, Inc. All rights reserved.
Affiliation:
Department of Community Medicine and Primary Care, Geneva University Hospitals, Geneva, Switzerland. nikolassamaras@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Abdominal Pain / diagnosis,  therapy
Accidental Falls
Aged* / statistics & numerical data
Alcoholism / diagnosis,  therapy
Coronary Disease / diagnosis,  therapy
Elder Abuse
Emergency Service, Hospital* / statistics & numerical data
Humans
Infection / diagnosis,  therapy
Mental Disorders / diagnosis,  therapy
Pharmaceutical Preparations / adverse effects
Polypharmacy
Risk Factors
Substance-Related Disorders / diagnosis,  therapy
Chemical
Reg. No./Substance:
0/Pharmaceutical Preparations

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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