Original ContributionsEarly revisit, hospitalization, or death among older persons discharged from the ED*,**
Section snippets
Study population
The Institutional Review Board of the University of Chicago approved the study. As previously described,10 research assistants attempted to approach all patients aged 65 or older who presented to the ED of the University of Chicago from October 16, 1995 to June 1, 1996. Because earlier pilot work suggested that few elderly patients present after midnight, enrollment was limited to patients who presented between the hours of 8 am and 12 midnight, 6 days per week, with random selection of the day
Characteristics of the sample
Of the 463 patients discharged from the ED, 346 (75%) completed the initial interview themselves, 34 (7%) participated in the initial interview with help from a proxy, and 83 (18%) were too ill or cognitively impaired to participate so a proxy completed the initial interview. Among these patients, 47% were older than 75 years, 63% were women and 84% were African American (Table 1).Characteristics Discharged from ED, N (%) Age, years 65 to
Discussion
We found that poor physical functioning, poor mental health, and lack of supplemental insurance were multivariate predictors of morbid events among older adults within 30 days of discharge from the ED. Physical functioning is a well-established predictor of outcomes among elderly patients.4, 20 A previous analysis of these data suggested that deficiencies in ADLs were associated with poor recovery after an ED visit.10 Mental health problems have also been implicated in increased morbidity and
Acknowledgements
The authors thank Annette Miller, RN and Michael Nerney for stewarding the data collection effort.
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Supported by grants from the Chicago Community Trust (no. 12212) and Retirement Research Foundation (no. 95-122). Drs Friedmann and Chin are Robert Wood Johnson Generalist Physician Faculty Scholars. Dr Friedmann is also supported by grant no. K08-DA00320 from the National Institute on Drug Abuse. Dr Chin was supported by grant no. K12-AG00488 from the National Institute on Aging Geriatric Academic Program.
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