World Journal of Emergency Medicine ›› 2018, Vol. 9 ›› Issue (1): 20-25.doi: 10.5847/wjem.j.1920-8642.2018.01.003
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Yuzeng Shen1(), Yee Chien Tay2, Edward Wee Kwan Teo3, Nan Liu4, Shao Wei Lam4, Marcus Eng Hock Ong1
Received:
2017-04-22
Accepted:
2017-09-20
Online:
2018-03-15
Published:
2018-03-15
Contact:
Yuzeng Shen
E-mail:shen.yuzeng@singhealth.com.sg
Yuzeng Shen, Yee Chien Tay, Edward Wee Kwan Teo, Nan Liu, Shao Wei Lam, Marcus Eng Hock Ong. Association between the elderly frequent attender to the emergency department and 30-day mortality: A retrospective study over 10 years[J]. World Journal of Emergency Medicine, 2018, 9(1): 20-25.
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URL: http://wjem.com.cn//EN/10.5847/wjem.j.1920-8642.2018.01.003
Table 1
Average per year FA3 attendance by period, 2005-2014
Parameters | All attendance (n=1,381,180) | 65 & above attendance (n=353,042) |
---|---|---|
Average per year | ||
Total attendance | 138,118 | 35,304 |
FA attendance | 30,523 | 11,067 |
FA share of attendance | 22.1 | 31.3 |
Average per year | ||
Unique attendance | 101,408 | 6,982 |
Unique FA attendance | 7,121 | 816 |
FA share of unique attendance | 7.0 | 11.7 |
Table 2
Patient and visit characteristics of 65 & above non-frequent attenders (FAs) vs. FAs, 2005-2014
Parameters | 65 & above non-FA (n=242,371) | 65 & above FA (n=110,671) | P values |
---|---|---|---|
Gender | < 0.001 | ||
Female | 54.0 | 51.5 | |
Male | 46.0 | 48.5 | |
Age | - | ||
65 & above | 100.0 | 100.0 | |
85 & above | 11.8 | 15.4 | |
Ethnicity | < 0.001 | ||
Chinese | 81.8 | 80.2 | |
Malay | 7.3 | 8.6 | |
Indian | 7.1 | 8.7 | |
Others | 3.7 | 2.5 | |
Distance to SGH-ED | |||
0 to <5 km | 29.0 | 32.8 | |
5 to <10 km | 29.1 | 26.1 | |
10 to <15 km | 27.2 | 26.8 | |
15 km or more | 14.7 | 14.4 | |
Transport | < 0.001 | ||
Ambulance | 19.6 | 23.9 | |
Day of attendance | < 0.001 | ||
Monday | 16.6 | 15.8 | |
Tuesday | 14.7 | 14.6 | |
Wednesday | 14.1 | 14.1 | |
Thursday | 14.1 | 14.1 | |
Friday | 14.3 | 14.2 | |
Saturday | 14.0 | 14.1 | |
Sunday | 12.3 | 13.2 | |
Time of attendance | < 0.001 | ||
00:00-05:59 hours | 6.5 | 8.8 | |
06:00-11:59 hours | 29.9 | 29.0 | |
12:00-17:59 hours | 39.5 | 36.0 | |
18:00-23:59 hours | 24.1 | 26.2 | |
Triage priority | < 0.001 | ||
P1 | 13.9 | 17.3 | |
P2 | 53.3 | 59.6 | |
P3/P4 | 32.8 | 23.1 | |
Attended previous year | 27.9 | 60.7 | < 0.001 |
FA with 3-6 visits | - | 81.2 | - |
FA with 7 or more visits | - | 18.8 | - |
Table 3
Outcome characteristics of 65 & above non-frequent attenders (FAs) vs. FAs, 2005-2014
Parameters | 65 & above non-FA (n=242,371) | 65 & above FA (n=110,671) | P-values |
---|---|---|---|
Median time to consultation | 36 | 32 | <0.001 |
Median time to disposition | 189 | 198 | <0.001 |
Admission | |||
Admitted | 57.4 | 70.8 | <0.001 |
Length of stay (median) | 6 | 6 | 0.803 |
Admission diagnosis | <0.001 | ||
Infectious diseases | 6.7 | 7.5 | |
Neoplasms | 2.5 | 3.3 | |
Immunity disorders | 5.3 | 7.9 | |
Blood diseases | 1.3 | 1.5 | |
Mental disorders | 0.3 | 0.4 | |
Nervous diseases | 4.3 | 1.9 | |
Circulatory diseases | 13.2 | 13.4 | |
Respiratory diseases | 8.6 | 12.0 | |
Digestive diseases | 8.3 | 9.0 | |
Genitourinary diseases | 3.7 | 5.6 | |
Skin diseases | 3.9 | 3.6 | |
Musculoskeletal | 4.9 | 3.7 | |
General symptoms | 23.5 | 24.5 | |
Injury and poisoning | 13.2 | 5.7 | |
ED observation ward | 4.0 | 2.5 | <0.001 |
30-day mortality rate | 5.4 | 5.4 | 0.764 |
Table 4
Univariate and multivariate analysis of factors associated with 30-day mortality
Parameters | Univariate odds ratio | Multivariate adjusted odds ratio | ||
---|---|---|---|---|
Gender | ||||
Female | 1 | |||
Male | 1.36 | (1.33, 1.4) | 1.21 | (1.17, 1.25) |
Age | ||||
65 & above | - | - | ||
Ethnicity | ||||
Chinese | 1 | |||
Malay | 0.98 | (0.93, 1.04) | 0.93 | (0.88, 0.99) |
Indian | 0.65 | (0.61, 0.70) | 0.69 | (0.64, 0.74) |
Others | 0.67 | (0.61, 0.73) | 0.64 | (0.58, 0.71) |
Distance to SGH-ED | ||||
0 to <5 km | 1 | |||
5 to <10 km | 0.91 | (0.88, 0.95) | 1.16 | (1.12, 1.21) |
10 to <15 km | 0.91 | (0.87, 0.94) | 1.15 | (1.11, 1.20) |
15 km or more | 0.96 | (0.92, 1.01) | 1.19 | (1.13, 1.25) |
Transport | ||||
Ambulance | 4.27 | (4.15, 4.4) | 2.72 | (2.63, 2.81) |
Day of attendance | ||||
Monday | 1.01 | (0.96, 1.06) | 1.03 | (0.97, 1.09) |
Tuesday | 0.99 | (0.94, 1.04) | 1.00 | (0.94, 1.06) |
Wednesday | 1.01 | (0.96, 1.07) | 1.01 | (0.95, 1.07) |
Thursday | 0.99 | (0.93, 1.04) | 0.98 | (0.92, 1.04) |
Friday | 1 | |||
Saturday | 0.98 | (0.92, 1.03) | 0.97 | (0.91, 1.03) |
Sunday | 1.14 | (1.08, 1.20) | 1.04 | (0.98, 1.11) |
Time of attendance | ||||
00:00-05:59 hours | 1 | |||
06:00-11:59 hours | 0.76 | (0.72, 0.80) | 1.10 | (1.04, 1.18) |
12:00-17:59 hours | 0.81 | (0.77, 0.86) | 1.19 | (1.12, 1.27) |
18:00-23:59 hours | 0.94 | (0.89, 0.99) | 1.17 | (1.10, 1.24) |
Triage priority | ||||
P1 | 1 | |||
P2 | 0.34 | (0.33, 0.35) | 0.45 | (0.43, 0.46) |
P3/P4 | 0.06 | (0.06, 0.07) | 0.14 | (0.13, 0.15) |
Attend previous year | 1.34 | (1.30, 1.38) | 1.31 | (1.26, 1.35) |
FA | 1.00 | (0.97, 1.04) | - | |
3-6 visits | 1.15 | (1.12, 1.19) | 0.77 | (0.75, 0.80) |
7 or more visits | 0.54 | (0.50, 0.59) | 0.36 | (0.33, 0.40) |
Time to consultation | 0.99 | (0.98, 0.99) | 1.00 | (1.00, 1.00) |
Time to disposition | 1.00 | (1.00, 1.00) | 1.00 | (1.00, 1.00) |
ED diagnosis | ||||
Infectious diseases | 1 | |||
Neoplasms | 4.32 | (4.06, 4.59) | 5.32 | (4.97, 5.69) |
Immunity disorders | 0.68 | (0.64, 0.73) | 0.75 | (0.69, 0.80) |
Blood diseases | 0.74 | (0.66, 0.83) | 1.03 | (0.91, 1.16) |
Mental disorders | 0.23 | (0.16, 0.34) | 0.33 | (0.22, 0.48) |
Nervous diseases | 0.12 | (0.10, 0.14) | 0.25 | (0.21, 0.29) |
Circulatory diseases | 0.55 | (0.52, 0.59) | 0.53 | (0.49, 0.56) |
Respiratory diseases | 1.06 | (1.00, 1.12) | 0.96 | (0.90, 1.02) |
Digestive diseases | 0.47 | (0.44, 0.50) | 0.73 | (0.68, 0.79) |
Genitourinary diseases | 0.56 | (0.51, 0.61) | 0.90 | (0.83, 0.98) |
Skin diseases | 0.25 | (0.23, 0.28) | 0.70 | (0.62, 0.79) |
Musculoskeletal diseases | 0.12 | (0.10, 0.13) | 0.31 | (0.27, 0.36) |
Symptoms | 0.36 | (0.34, 0.39) | 0.60 | (0.56, 0.64) |
Injury and poisoning | 0.17 | (0.16, 0.19) | 0.32 | (0.29, 0.35) |
ED observation ward | 0.09 | (0.07, 0.12) | 0.14 | (0.11, 0.17) |
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