Frailty Assessment in a Cohort of Elderly Patients with Severe Symptomatic Aortic Stenosis: Insights from the FRailty Evaluation in Severe Aortic Stenosis (FRESAS) Registry.

BACKGROUND: Precise evaluation of the degree of frailty is a fundamental part of the global geriatric assessment that helps to avoid therapies that could be futile. Our main objective was to determine the prevalence of frailty in a specific consult of patients undergoing aortic valve replacement. METHODS: From May 2018 to February 2020, all consecutive patients ≥75 years old, with severe symptomatic aortic stenosis, undergoing valve replacement in the Principality of Asturias (Northern Spain) were evaluated. RESULTS: A total of 286 patients were assessed. The mean age was 84 ± 4.01 years old; 175 (61.2%) were female. The short performance physical battery score was 8.5 ± 2.4 and the prevalence of frailty was 19.6% (56 patients). In the multivariable analysis, age, Barthel index and atrial fibrillation were independent predictors of frailty. CONCLUSIONS: The prevalence of frailty in our sample patients undergoing aortic valve replacement, evaluated by a standardized protocol, was 19.6%.

Impacto del paciente anciano en los servicios de urgencias hospitalarios / Impact of the elderly patient in the emergency department

Introducción. El envejecimiento poblacional, el aumento de pacientes con enfermedades crónicas y la presencia excesiva de visitas no urgentes se consideran las grandes culpables del aumento de carga asistencial en los servicios de urgencia hospitalarios (SUH). El objetivo del estudio es analizar el impacto que ejerce el paciente anciano en los SUH, comparándolo con el resto de la población. Material y métodos. Estudio observacional, descriptivo y retrospectivo, de los 92.627 pacientes que acudieron al servicio de urgencias de los hospitales del área sanitaria iv del Servicio de Salud del Principado de Asturias durante todo el año 2009. Se analizaron el número de visitas totales, triaje de Manchester, destino al alta de los pacientes, estancia media, presión horaria durante las 24horas, pruebas complementarias, reclamaciones y consultas al servicio social. Se comparó la base de datos entre mayores y menores de 70 años. Resultados. Un total de 28.965 (31.27%) pacientes eran≥70años, con una tasa de frecuentación del 52,29% (frente a 25,70% en<70años). Los pacientes mayores presentaban una mayor prioridad en la atención por gravedad, se les realizaron más pruebas complementarias, con una mayor estancia media, tenían una mayor probabilidad de ingreso, de ser exitus y de necesidad de valoración por servicio social. Conclusiones. Los pacientes ancianos acuden de forma justificada a los SUH y con un patrón de uso significativamente diferente a los adultos jóvenes

Introduction. The aging of the population, chronic diseases, and non-urgent visits to the Emergency departments (ED) are considered the reasons for the increase of the demand of care. The aim of this study is to analyse the impact of the older population in the ED, when compared to a younger population. Material and methods. An observational, descriptive and retrospective study including an analysis of the 92,627 patients that attended the ED in Hospitals from Health Area IV belonging to the Principality of Asturias Health Services during 2009. The analysis included the number of visits, degree of urgency when arriving at the ED, length of stay (LOS), destination after ED assessment, demand of care per time of day, laboratory tests, and radiology, complaints, and social services consultation. A comparison was made between the data of patients over and below 70 years of age. Results. At total of 28,965 (31.27%) patients were over 70 years of age, with a frequency rate in the ED of 52.29% (25.70% in those less than 70 years). Patients over 70 years had a higher priority attention through the Manchester triage scale, receiving more laboratory tests, with a higher LOS. They also had a higher probability of being seen by social services, of being admitted, and death. Conclusions. Older patients consult the ED with more justifiable reasons than the younger adult population

[Impact of the elderly patient in the emergency department]. / Impacto del paciente anciano en los servicios de urgencias hospitalarios.

INTRODUCTION: The aging of the population, chronic diseases, and non-urgent visits to the Emergency departments (ED) are considered the reasons for the increase of the demand of care. The aim of this study is to analyse the impact of the older population in the ED, when compared to a younger population. MATERIAL AND METHODS: An observational, descriptive and retrospective study including an analysis of the 92,627 patients that attended the ED in Hospitals from Health Area IV belonging to the Principality of Asturias Health Services during 2009. The analysis included the number of visits, degree of urgency when arriving at the ED, length of stay (LOS), destination after ED assessment, demand of care per time of day, laboratory tests, and radiology, complaints, and social services consultation. A comparison was made between the data of patients over and below 70 years of age. RESULTS: At total of 28,965 (31.27%) patients were over 70 years of age, with a frequency rate in the ED of 52.29% (25.70% in those less than 70 years). Patients over 70 years had a higher priority attention through the Manchester triage scale, receiving more laboratory tests, with a higher LOS. They also had a higher probability of being seen by social services, of being admitted, and death. CONCLUSIONS: Older patients consult the ED with more justifiable reasons than the younger adult population.