Correlation between age, emergency department length of stay and hospital admission rate in emergency department patients aged ≥70 years.

ABSTRACT

BACKGROUND: Interdisciplinary emergency departments (EDs) are confronted with trauma and nontrauma patients of any age group. Length of stay (LOS) and admission rates reflect both disease complexity and severity. OBJECTIVE: To evaluate LOS and admission rates in different age groups according to traumatic and nontraumatic etiologies. PATIENTS AND METHODS: During May 2011 a total of 4,653 adult patients (defined as ≥18 years old) seen in the ED of our municipal hospital were evaluated for their primary problem, Emergency Severity Index, LOS and admission rate. 1,841 trauma patients (mean age 51.9 years; SD 22.5 years) and 2,812 nontrauma patients (mean age 60.0 years; SD 20.4 years) were included. RESULTS: Median LOS in the ED was 141 h (trauma) and 152 h (nontrauma). Trauma patients aged ≥70 years spent more time in the ED than nontrauma patients of this age group (patients aged ≥70 years median 208 vs. 156 h; p < 0.0001). However, no significant difference was found in patients aged <70 years (133 vs. 148 h; p = 0.64). Comparing older with younger patients, median LOS within the ED was about 8 min longer in nontrauma patients aged ≥70 years (p = 0.22) and about 35 min longer in trauma patients aged ≥70 years (p < 0.00001). CONCLUSIONS: The correlation between age and LOS is stronger for trauma patients, which might indicate a special need for geriatric expertise in elderly trauma ED patients. Thus an interdisciplinary approach including surgical and geriatric expertise may be advantageous.