Retrospective 3-year statistical evaluation of demographic and clinical characteristics of geriatric patients admitted to the emergency department critical care unit

Retrospective 3-Year Statistical Evaluation of Demographic and Clinical Characteristics of Geriatric Patients Admitted to the Emergency Department Critical Care Unit Objective: The aim of our study was to evaluate the demographic and clinical characteristics of elderly patients presenting to the Emergency Department Red Zone of Çukurova University Department of Emergency Medicine over the past three years, including age, gender, presenting complaints, ICD-10 diagnosis codes, treatment outcomes (admission, discharge, ward stayed), and average hospital costs. Material and Method: Our study was planned retrospectively and cross-sectionally. Data of geriatric patients presenting to the Emergency Department of Çukurova University Department of Emergency Medicine between November 2019 and December 2022 were compiled. A total of 1793 patients aged 65 and over who visited the emergency department during this period were included. The demographic characteristics (age-gender), triage categories, arrival types, admission dates, presenting complaints, ICD-10 diagnosis codes, treatment outcomes (admission-discharge-ward stayed), and average hospital costs of the patients were scanned and recorded through emergency department cards, admission files, and hospital information management system. Results: Of the 1793 patients evaluated in the study, 51.4% were male and 48.6% were female. Their mean age was determined to be 76.9±8.2 years. The distribution of patients according to age groups was as follows: 44.4% were in the 65-74 age group, 36.6% were in the 75-84 age group, 16.8% were in the 85-94 age group, and 2.1% were aged 95 and over. When the distribution of visits was examined by year, 7.1% were in 2019, 41.6% were in 2020, 17.5% were in 2021, and 33.8% were in 2022. Of the patients who presented to the emergency department, 95.6% were in the green zone, 3.7% were in the yellow zone, and 0.7% were in the red zone. While 95% of the patients presented in emergency situations, 3.6% were legal cases, and 1.3% were traffic accidents. One percent of the patients died during their emergency department visit, 26% were admitted to services, 15.6% were admitted to intensive care units, and 57.3% were discharged. The average hospital cost was determined to be 4102.9±12697.4 TL. Patients were divided into two groups: 65-84 years old and 85 years and older; the female proportion in the 85 years and older group was statistically significantly higher than in the 65-84 age group (p=0.001). There was no statistically significant difference between the groups in terms of triage category, arrival type, and outcome (p>0.05). The median cost was 749.1 TL in the 65-84 age group and 994.8 TL in the 85 and over group; this difference was statistically significant (p=0.002). Fifty-eight point three percent of the patients were not admitted. The most common services admitted to were the emergency department (9.5%), COVID-19 service (2.5%), and chest diseases service (1.9%). The most common admissions to intensive care units were coronary intensive care (6.6%), neurology intensive care (3.3%), and internal medicine intensive care (3.1%). The distribution of presenting complaints was shown in Table 10; the most common complaints were dyspnea (32.7%), altered consciousness (13%), and chest pain (8.5%). The most common diagnoses were W83 (13.4%), W84 (7.5%), R07.3 (6.9%), G93.9 (6.5%), and R51 (5.1%). Conclusion: The findings indicate that elderly patients spend longer periods in the emergency department and that chronic diseases have a significant impact on treatment options. These results support the need for clinical practice and policy development to improve emergency department services for elderly patients and emphasize the importance of establishing national monitoring systems. Keywords: Emergency Department, Geriatrics, Red Zone, Triage