Examination of patients over 65 years admi̇ted to a emergency department of university hospital

Introduction and aim: In this study; retrospective admited of patients over the age of 65 who applied to the emergency service or those who were admitted to the intensive care unit were examined, and their application complaints, frequency of admission, examinations performed in the emergency department, imaging methods, preliminary diagnoses, hospitalization rates, the most hospitalized departments, the last diagnoses, the patient's discharge and mortality status and the relationships between these parameters to be evaluated were evaluated. Material and methods: In this study, patients over the age of 65 who applied to İnönü University Faculty of Medicine Turgut Özal Medical Center Emergency Medicine Department between 01 April 2020 - 10 July 2020 were retrospectively examined. Admited were identified through the hospital health information management system. After the patient admited were determined, the medical records of the patients were examined. A patient follow-up form was created for the patients included in the study. Patients' vital signs, physical examination findings, complaints of admission to the emergency department, preliminary and final diagnosis in the emergency department, the service or intensive care unit, the length of stay in the service and intensive care unit, discharge or death status in the service or intensive care unit, additional diseases, number of admited, desired consultations, radiological examinations and laboratory values were examined. Results: In this study, it was determined that 31.16% of all patients over 65 years of age who applied to the emergency department were hospitalized. It was determined that 58.8% of the patients were male, 41.2% were female, and the mean age of all patients was 76.29. The majority of the patients were between the ages of 65 and 74. In our study, it was observed that 301 (44.9%) of the patients were hospitalized in intensive care units. The mean hospital stay of the patients was 9 days. The most common comorbidity in the patients was DM. 16.9% of all patients died in the unit they were admitted to and the rest were discharged. While the department with the highest number of deaths numerically was the covid service, the department with the highest number of deaths proportionally was medical oncology. It was determined that the department with the most hospitalizations was cardiology. When the hospitalizations were examined, the most common diagnosis was ACS (13.58%). It was observed that the patients in our study applied to the emergency department most frequently with the complaint of shortness of breath (18.2%). The mortality rate of the patients hospitalized in the intensive care unit was found to be significantly higher than the patients hospitalized in the ward. It was determined that the mean age and length of hospital stay of the patients who died were significantly higher than those who were discharged. It was found that the deceased patients were significantly hypotensive and tachycardic compared to the discharged patients. BUN, creatinine, total bilirubin, direct bilirubin, AST, ALT, ALP, GGT, LDH, neutrophil, lymphocyte, INR, APTT, CRP values and neutrophil/lymphocyte ratio of the patients who died in the hospital they were admitted to were significantly higher than the patients who were discharged. protein, albumin, calcium and hemoglobin values were found to be significantly lower. CT was requested as an imaging test in 78.96% of the patients. Conclusion: As a result of this study, when geriatric patients are evaluated in terms of their application to the emergency department, their follow-up and results; It was determined that hospitalization rates in hospitals and intensive care units were high, they most frequently applied to the emergency department with the complaint of shortness of breath, they were mostly hospitalized in the cardiology department, the length of hospitalization was long, and the death rate was high. In addition, it has been determined that blood tests and imaging methods have been studied intensively and it is very important to evaluate them well. Key words: Emergency, Covid, Geriatrics, Mortality, Intensive Care