Predictive factors of the risk of rehospitalization and loss of autonomy in elderly people admitted to the emergency department: a pilot study

By Charlotte Gangneux, Mathilde Charpigny, Claire Patry, Anne Leclercq

Introduction: the number of elderly patients admitted to emergency departments (EDs) continues to rise each year. However, due to time and structural constraints, these facilities do not allow for optimal identification of patients at risk of rehospitalization and loss of independence.
Objective: to identify the characteristics of patients over the age of 75 discharged from the ED without indications for hospitalization, and to illustrate the importance of advanced practice nurses (APN) in identifying predictive factors of loss of independence.
Method: a prospective, single-center, observational pilot study of a cohort of 67 patients in an emergency department.
Results: the study allowed the researchers to characterize a female, aging, and vulnerable patient population. Re-evaluation at the six-month mark revealed a functional decline in 23% of patients. Relevant predictive autonomy loss factors including recent cognitive decline, hearing impairment, and weight loss are put forward for future research.
Discussion: these results, in line with the findings of previous studies, highlight the potential added value of APNs in indentifying the functional decline within this patient population.
Conclusion: given the diverse, complex, and fragile health condition of elderly patients when discharged from the emergency department, APNs play a key role in improving care and preventing loss of independence within this patient population.

  • frail elderly
  • emergency departments
  • independence
  • functional decline
  • advanced practice nurse
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