Elderly A&E patients face higher risk of disability

Elderly patients are more at risk of disability after a hospital stay. Picture: Getty Images
Elderly patients are more at risk of disability after a hospital stay. Picture: Getty Images
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Elderly people taken to A&E for an illness or injury are more likely to suffer a disability six months after discharge, a new study warned.

Researchers called for specialist geriatric nurses to be on hand in emergency departments to check up on older people before they are sent home.

Patients discharged from the emergency department are also at risk for functional decline

Dr Justine M Nagurney

There is a growing body of evidence that older adults are more at risk of disability and decline in function after being admitted to hospital, as extended stays can leave elderly patients vulnerable to infection, dependency and depression.

In one of the first studies of its kind, American researchers examined what happens to people over 65 years old, the majority of who are discharged from casualty without being admitted.

The Yale University study, published in the Annals of Emergency Medicine journal, found that people who were sent home from casualty departments had higher disability scores than those who did not, after examining the medical records of more than 700 older adults over a 14-year period.

Lead author Dr Justine M. Nagurney, a resident in Emergency Medicine at Yale New Haven Hospital, said: “We know that if older persons go to the hospital and are admitted, they are at increased risk of disability and functional decline.

“This study shows that patients discharged from the emergency department, meaning that they were deemed well enough to return home, are also at risk for functional decline.

“We should be doing something to address that.”

The researchers used a scoring system to assess the presence and severity of disability among pensioners who had visited emergency departments and been discharged, those who had been hospitalised after an A&E visit, or those who had not visited casualty at all.

They found that people who were rushed to casualty were also more likely to be living in a nursing home, and to die, in the six-month period after going to the A&E.

The patients who were admitted to hospital from A&E had the highest disability scores.

Dr Nagurney suggested bringing in specialists in elderly medicine to help assess patients before they leave A&E to see if they needed follow-up care.