Short‐Term Outcomes of Elderly Patients Discharged from an Emergency Department

Abstract

To determine the short-term functional and medical outcomes and predictors of outcome following discharge from an acute hosptial emergency department, 100 elderly (.gtoreq. 65 yr) and 100 nonelderly (< 65 yr) patients were studied prospectively. Patients were interviewed at three days and again at three weeks following energency department discharge. The number of new prescriptions given to both groups in the energency department was similar (elderly 41%; nonelderly, 31%). The elderly were as likely as the nonelderly to know the correct name (elderly, 88%; nonelderly, 87%), dosage schedule (elderly, 90%; nonelderly, 90%) and purpose (elderly, 85%; nonelderly, 94%) of their new medications. There was no difference in patients'' understanding of the diagnosis (elderly, 72%; nonelderly, 72%) or in mediation complicance (elderly, 81%; nonelderly, 74%). Elderly patients were more likely to keep scheduled follow-up appointments (87% vs 65%; P < .05). Despite these similarities the elderly had worse medical outcomes at three weeks; 67% of the elderly were better and 205 were worse, including seven patients who required interim hospitalization, four of whom died. In contrast, 82% of the nonelderly were better and only 4% were worse (P < .01). None of the nonelderly required hospitalization or had died. Functional impairments were more common in the elderly both at baseline (elderly, 26%; nonelderly, 6%; P < .01) and at three weeks (elderly, 27%; nonelderly, 5%; P < .001). Independent predictors of poor medical outcome included age .gtoreq. (P < .009) and functional impairment at baseline (P < .022). Older patients with impaired functional status who are discharged from an emergency department should be targeted for close medical surveillance and ready access to health services.