Evaluation of pre-hospital delay in emergency department admissions among geriatric patients

Introduction and Aim: Delays in emergency department (ED) admissions contribute significantly to increased morbidity and mortality in many medical conditions. Geriatric patients, in particular, are at higher risk for such delays. This study aimed to identify factors associated with delayed ED admissions in the geriatric population. Materials and Methods: This prospective study recorded the time of symptom onset and the time of initial ED admission. Based on the duration between these two points, patients were categorized into early, intermediate, and delayed admission groups. Participants completed a structured questionnaire assessing sociodemographic characteristics, symptoms, and comorbidities. The Charlson Comorbidity Index was used to evaluate comorbidity burden, the Katz Index to measure functional dependency, the Emergency Severity Index (ESI) for triage scoring, and the AM SAD depression assessment tool to assess the presence of depression. Results: Delayed ED admissions were significantly associated with upper respiratory tract infection symptoms, higher scores on the AMSAD depression assessment tool, and elevated ESI triage scores. In contrast, admissions due to syncope and receiving a diagnosis of acute coronary syndrome in the ED were significantly associated with early presentation. Conclusion: This study identified specific factors contributing to delayed ED admissions among geriatric patients. As similar studies increase, risk factors leading to delays in this population can be more precisely defined. Identifying these factors may support the assessment of patients' needs for home care or close follow-up. Keywords: Geriatrics, pre-hospital delay, risk factors, emergency department