9/4/2023 0 Comments Ed visits![]() The Central Institute, a tertiary university hospital, is the main unit within the Hospital das Clínicas complex. Hospital das Clínicas (HC) is a teaching hospital complex with 2200 beds of University of São Paulo Medical School, serving as the referral center for the whole state. São Paulo, capital of São Paulo State is the largest city in Brazil, with an estimated population of 12 millions of people. Study periodġst January 2009 to 31st December 2013. Observational cross-sectional analytic study. To describe the demographic profile of ED users in a tertiary hospital over a 5-year period and to investigate differences in outcomes by sex and age. As far as we know, no other study in Latin America has analyzed the impact of demographic changes in tertiary ED attendance. In the Brazilian health system, complex and severely ill patients and those requiring specialized urgent procedures are referred to tertiary level care. ![]() Furthermore, compared to younger adults, older ED patients on average have earlier ED returns, longer hospital stays, greater resource use, and higher rates of hospitalization and adverse outcomes. The increase in emergency department (ED) visits by older individuals is greater than the rate of growth of this population in North America, Europe, Asia and Oceania. Īlthough older people are a heterogenous group in terms of physiological reserve and rate of functional decline, multimorbidity and use of health services tend to increase as age rises. While this age group is likely to double by 2050, the population younger than 15 is expected to remain stable. People aged 60 and over accounted for 13% of the global population in 2017. The average age of the global population is rising at an increasing rate. Old-older people are at the greatest risk and demand further subgroup stratification. In tertiary ED, age is an important risk factor for hospitalization and mortality, but not for ICU admission. The ORs for hospitalization, ICU admission and mortality associated with the old-older group were 3.49 (95% CI = 3.15–3.87), 1.27 (1.15–1.39) and 5.93 (5.29–6.66) respectively, with young adults as the reference. The proportions of visits and admissions attributed to young adults decreased annually, while those of people aged 60 or over increased. LOS and ICU-LOS were similar across age-groups. Hospitalization, ICU admission and mortality rates increased with older age in both sexes. Old-older patients accounted for 5.1% of ED visits, 9.5% of admissions and 10.1% of ICU admissions. Older age-groups represented 26.6% of 333,028 ED visits, 40.7% of admissions, 42.7% of ICU admissions and 58% of all deaths. The significance level was 5% with Bonferroni correction. We calculated descriptive statistics, built generalized linear mixed models for each outcome and estimated Odds Ratios (95% CI) for the independent categorical variables. Other variables included sex, reason for attendance, time of ED visit, mode of presentation, type of hospitalization, main procedure, length of hospital stay (LOS) and length of ICU stay (ICU-LOS). The primary outcomes were hospitalization and mortality the secondary outcome was ICU admission. Participants: patients aged 18 years or older attending a tertiary ED (2009–2013). Setting: Emergency Department, tertiary university hospital, São Paulo, Brazil. Methodsĭesign: Observational cross-sectional analytic study. Aim: To describe the sociodemographic characteristics and outcomes of tertiary Brazilian ED users. There is a disproportional increase in Emergency Department (ED) visits by older people worldwide. ![]() ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |