Aging Clinical Trial
Official title:
Comprehensive Geriatric Assessment in Emergency Department. Impact on Health and Patient Flows
Purpose Frailty and multi-morbidity have been associated with increased pressure on Emergency
Departments (ED), higher hospital admissions and more risks for patients arising from the ED
stay. The advantages of developing specific attention to frailty in ED have been highlighted.
The benefits of these approaches are related to patients but also to organizations. The aim
is to present how a Program of Care for Frailty (PCF) in an ED impacts on patient health and
flows.
Objective is to analyze the clinical impact of Comprehensive Geriatric Care (CGA) in the
Emergency Department (ED) and on patient flows Setting: A tertiary, teaching, 550-bed urban
hospital, with 80,000 adult patients/year ED attendances (43%≥65 years). Two periods are
compared: First period (before CGA implantation) del 01/04/2016 - 15/04/2016 and second
period (after) 01/04/2017 - 15/04/2017
Purpose Frailty and multi-morbidity have been associated with increased pressure on Emergency
Departments (ED), higher hospital admissions and more risks for patients arising from the ED
stay. The advantages of developing specific attention to frailty in ED have been highlighted.
The benefits of these approaches are related to patients but also to organizations. The aim
is to observe how a Program of Care for Frailty (PCF) in an ED impacts on patient health and
flows.
Objective
1. Analyze the clinical impact of Comprehensive Geriatric Care (CGA) in the Emergency
Department (ED).
2. Analyze the impact on patient flows following the implementation of a Comprehensive
Geriatric Assessment in the Emergency Department (ED).
Methods Setting: A tertiary, teaching, 550-bed urban hospital, with 80,000 adult
patients/year ED attendances (43%≥65 years).
First period (before CGA implantation) del 01/04/2016 - 15/04/2016 and second period (after)
01/04/2017 - 15/04/2017 Intervention: In the second period, the AGI was carried out by the
emergency medical teams. It basically consists of care adapted to the special needs of
geriatric patients, with systematic screening of delirium, delirium prevention, early
treatment, pain management with scales adapted to chronicity, conciliation of medication to
discharge from the emergency department, among others A comparison will be made of health
outcomes and patient flows in ED: direct discharge, admission to emergency observation unit,
admission to short stay unit, transfer to intermediate hospital, admission, admission to
critical care area, death, time spent in the Emergency Department (ED) and in intermediate
hospital, mortality during admission at one and six months, re-entry or reconsultation in the
Emergency Department at 30 days and six months will be measured.
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