Details

Autor(en) / Beteiligte

• Arslan, Tuğba
• Saraç, Zeliha Fulden
• Ersel, Murat
• Savas, Sumru

Titel

Evaluation of falls in older persons in the emergency department during the early Coronavirus-2019 pandemic and pre-pandemic periods

Ist Teil von

• European geriatric medicine, 2023-12, Vol.14 (6), p.1373-1381

Ort / Verlag

Cham: Springer International Publishing

Erscheinungsjahr

2023

Link zum Volltext

Quelle

SpringerLink

Beschreibungen/Notizen

• Key summary points Aim This study aimed to investigate the clinical status, outcomes, and healthcare costs of older patients who presented at the emergency department (ED) with falls in the periods before and during the Coronavirus disease-2019 (COVID-19) pandemic. Findings Though the number of fall-related presentations of older persons to the ED, comorbidity burden, consultations, and the length of stay in the ED was lower, direct costs were higher during the pandemic period than the pre-pandemic period, particularly for COVID-19 positive older patients admitted to the ED with falls, and those patients were with poorer outcomes. Message As older patients with falls and multi-comorbidities might have experienced difficulties to reach the ED or avoided to apply during the pandemic period, strengthening community-based health services, and organizing EDs according to the needs of older patients are critical measures for crises situations. Purpose This study aimed to investigate the clinical characteristics, outcomes and healthcare costs of older patients presented to the emergency department (ED) with falls in the periods before and during the Coronavirus disease-2019 (COVID-19) pandemic. Methods Hospital records one year before and after the onset of the COVID-19 pandemic were retrospectively analyzed through “International Statistical Classification of Diseases-10th Revision” codes. Age, gender, falls, triage classification, length of stay (LOS) in the hospital and the ED, COVID-19 status, Glasgow Coma scale, consultations-comorbidities, injury status, outcomes in the ED, and costs were recorded. Results The study comprised of 3187 patients aged ≥ 65 years admitted to the ED of a university hospital between March 2019 and 2021. In terms of pre-pandemic and pandemic periods; older patients presenting with falls to the ED, consultations, Charlson Comorbidity Index, and LOS in the ED were lower in the pandemic period, but costs were higher ( p  = 0.03, p  = 0.01, p  = 0.01, p  = 0.01 and p  = 0.02, respectively). Hospitalization/mortality rates were higher in COVID-19 positive patients (77.2%) than in COVID-19 negative patients (4.6%) within the pandemic period and the patients in the pre-pandemic period (22.8%), and the costs, as well (both p  = 0.01). Conclusion Though the number of fall-related presentations of older persons to the ED, comorbidity burden, consultations, and the LOS in the ED was lower, direct costs were higher during the pandemic period, particularly for COVID-19 positive older patients admitted to ED with falls than the pre-pandemic period, and those patients were with poorer outcomes.