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114 Comprehensive geriatric assessment in the emergency department: a prospective cohort study of process, clinical and patient-reported outcomes
  1. Íde O’Shaughnessy1,2,
  2. Damien Ryan3,
  3. Katie Robinson2,
  4. Aoife Whiston2,
  5. Louise Barry4,
  6. Aoife Synnott5,
  7. Aoife McCarthy1,
  8. Bryan Jones6,
  9. Eoin Moriarty7,
  10. Ida Carroll7,
  11. Aoife Leahy7,
  12. Margaret O’Connor7,
  13. Collette Devlin2,
  14. Gillian Corey2,
  15. Deirdre Hartigan2,
  16. Fiona Steed8,
  17. Lenora Carey1,
  18. Elaine Shanahan7,
  19. Denys Shchetkovskyy3,
  20. Rose Galvin2
  1. 1Department of Occupational Therapy, University Hospital Limerick, Ireland
  2. 2School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Ireland
  3. 3Limerick EM Education Research Training (ALERT), Emergency Department, University Hospital Limerick, Ireland
  4. 4Department of Nursing and Midwifery, University of Limerick, Ireland
  5. 5Department of Physiotherapy, University Hospital Limerick, Ireland
  6. 6Department of Medical Social Work, University Hospital Limerick, Ireland
  7. 7Department of Ageing and Therapeutics, University Hospital Limerick, Ireland
  8. 8Department of Health, Dublin, Ireland
  9. *denotes presenting author


Background Comprehensive geriatric assessment (CGA) has been shown to improve outcomes in hospitalised older adults; however, there is currently no compelling evidence to support CGA interventions within the emergency department (ED). This study aimed to explore the process, clinical and patient-reported outcomes of older adults who received an interdisciplinary CGA in the ED over a six-month period after their initial ED attendance.

Methods A prospective cohort study recruiting older adults aged ≥ 65 years who presented to the ED of a university teaching hospital in the mid-west of Ireland. Baseline assessment data comprising of a battery of demographic variables and validated indices were obtained at the index ED attendance. Telephone interviews were completed with participants at 30- and 180-day follow-up. The primary outcome was incidence of hospital admission following the index ED attendance. Secondary outcomes included participant satisfaction, incidence of functional decline, health-related quality of life, incidence of unscheduled ED re-attendance(s), hospital (re)admission(s), nursing home admission, and death.

Results A total of 133 participants (mean age 82.43 years, standard deviation = 6.89 years; 71.4% female) were recruited; 21.8% of the cohort were admitted to hospital following the index ED attendance with a significant decline in function reported at hospital discharge (Z = 2.97, p = 0.003). Incidence of 30- and 180-day unscheduled ED re-attendance was 10.5% and 24.8%, respectively. The outcome at the index ED attendance was a significant predictor of adverse outcomes whereby those who were discharged home had significantly lower odds of multiple adverse outcomes at follow-up.

Conclusion CGA in the ED may improve outcomes by mitigating against the adverse effects of potentially avoidable hospital admissions and focusing on integration of services across the healthcare system.

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