J Korean Acad Community Health Nurs.  2016 Dec;27(4):327-336. 10.12799/jkachn.2016.27.4.327.

Characteristics and Mortality Risk Factors in Geriatric Hospital Patients visiting One Region-wide Emergency Department

• Kim KW
• Jang S

• KMID: 2366960
• DOI: http://doi.org/10.12799/jkachn.2016.27.4.327

Abstract

PURPOSE
This study was to examine the clinical characteristics and mortality risk factors of geriatric hospital patients who visited one region-wide emergency department (ED). It's basically meant to develop criteria for the patient management of geriatric hospitals and to provide related information.
METHODS
A retrospective research study was implemented using electronic medical records. The subjects in this study included 484 geriatric hospital patients who were selected from among 15,994 patients that visited one region-wide ED between January 1, 2014, and December 31, 2015.
RESULTS
There were significant differences in death, a change for the better and no change for the better, which were results of treatment, according to the length of stay in hospital, hospitalization in a general ward, not having an operation or surgery, the presence or absence of malignant neoplasm, the insertion of foley catheter, intubation, ventilator and the insertion of central venous catheter.
CONCLUSION
The results of this study suggest that a patient management system is necessary in geriatric hospitals and that competent healthcare workers who can properly respond to emergencies are required as well.

Keyword

Length of stay; Hospital; Mortality; Emergency department

MeSH Terms

Catheters
Central Venous Catheters
Delivery of Health Care
Electronic Health Records
Emergencies*
Emergency Service, Hospital*
Hospitalization
Humans
Intubation
Length of Stay
Mortality*
Patients' Rooms
Retrospective Studies
Risk Factors*
Ventilators, Mechanical

Reference

1. Statistics Korea. 2014 elderly statistics in Korea [Internet]. Seoul: Statistics Korea;2014. cited 2016 March 26. Available from: http://www.stat.go.kr.

2. Lee HJ, Kim JY, Kim SH. An analysis of the difference between importance and satisfaction of selection attributes and reuse intention in long term care hospital for elderly patient caregivers. Korean J Hosp Manag. 2015; 20(4):50–61.

3. Kim SY. The clinical features and hospital course of patients admitted to a geriatric hospital: Analysis of 600 registered cases [master's thesis]. [Chuncheon]: Hallym University;2008. 30.

4. Lee DH, Lee JS. Long term care center and geriatric illness. Korean J Clin Geriatr. 2012; 13(4):133–152.

5. Kim EJ, Gu MO. Recognition for nursing competency importance, nursing competency level, and their influencing factors of nurses in the long-term care hospitals. J Korea Acad Ind Coop Soc. 2015; 16(3):1989–2001.

6. Yang YH. Prevalence and precipitating factors for delirium in elderly patients admitted to long-term care hospitals or to general hospital. J Korean Acad Fundam Nurs. 2010; 17(1):26–34.

7. Yoon SH, Kim BS, Kim SY. Development and validation of the korean patient safety culture scale for nursing homes. J Korean Acad Nurs. 2013; 43(3):379–388. DOI: 10.4040/jkan.2013.43.3.379.

8. Lee SH. Multi-level analysis of factors related to quality of service in long-term care hospitals. J Korean Acad Nurs. 2009; 39(3):409–421. DOI: 10.4040/jkan.2009.39.3.409.

9. Lee SH. Identification of factors related to quality of service in long term care hospitals using multilevel analysis [dissertation]. [Seoul]: Yonsei University;2009. 94.

10. Lee DH, Park KW. Long-term care hospital and the role of neurologist. J Korean Neurol Assoc. 2014; 32(1):1–7.

11. Kim HS. The service level and related factors of charged care facilities for the aged. J Welf Aged. 2009; 44:373–392.

12. Jung HY, Jung YK. Recognition and performance level of hospital infection control in nurses of long-term care hospital. Korean J Health Serv Manag. 2013; 7(4):131–141.

13. Park MW, Park KH, Cho JH, Park HY, Kwon IH, Yeo WH, et al. Characteristics of geriatric trauma patients transferred from long-term care hospitals: A propensity score matched analysis. J Korean Soc Emerg Med. 2014; 25(3):312–317.

14. Hay RJ, Steer AC, Engelman D, Walton S. Scabies in the developing world-its prevalence, complications, and management. Clin Microbiol Infect. 2012; 18(4):313–323. DOI: 10.1111/j.1469-0691.2012.03798.x.

15. Cho HJ, Kim DH, Han KS, Park JS, Moon SW, Lee SW, et al. Analysis of emergency department patients transferred from geriatric hospitals: Case series descriptive study. J Korean Soc Emerg Med. 2011; 22(5):531–535.

16. Avelino-Silva TJ, Farfel JM, Curiati JA, Amaral JR, Campora F, Jacob-Filho W. Comprehensive geriatric assessment predicts mortality and adverse outcomes in hospitalized older adults. BMC Geriatr. 2014; 14:129. DOI: 10.1186/1471-2318-14-129.

17. Lee EK, Ji EJ. Analysis of older patients using a regional emergency center. J Korean Gerontol Nurs. 2009; 11(1):71–80.

18. Wang HE, Shah MN, Allman RM, Kilgore M. Emergency department visits by nursing home residents in the united states. J Am Geriatr Soc. 2011; 59(10):1864–1872. DOI: 10.1111/j.1532-5415.2011.03587.x.

19. Briggs R, Coughlan T, Collins R, O'Neill D, Kennelly SP. Nursing home residents attending the emergency department: Clinical characteristics and outcomes. QJM: Monthly Journal of the Association of Physicians. 2013; 106(9):803–808. DOI: 10.1093/qjmed/hct136.

20. Lee BO, Shin EJ. Severity of elderly patients using one region wide emergency medical center. J Korean Gerontol Nurs. 2008; 10(2):164–172.

21. Fortinsky RH, Madigan EA, Sheehan TJ, Tullai-McGuinness S, Kleppinger A. Risk factors for hospitalization in a national sample of medicare home health care patients. J Appl Gerontol. 2014; 33(4):474–493. DOI: 10.1177/0733464812454007.

22. An HS, Kim HJ, Byun JY, Song JY. Patient care and management in long term care hospitals. Research Reports. Seoul: Research Institute for Healthcare Policy;2015. 01. Report No.: 2014-06.

23. Park JW, Park HI, Shim MB, Lee CJ, Bae JK, Je SM, et al. Analysis of factors affecting length of hospital stay in geriatric patients transferred from long-term care hospitals. J Korean Soc Emerg Med. 2015; 26(2):165–171.

24. Yang SH, Kweon YR. Recognition of skin infection and infection management practice on caregivers in geriatric hospital. J Korea Contents Assoc. 2014; 14(12):808–817.

25. Albert M, McCaig LF, Ashman JJ. Emergency department visits by persons aged 65 and over: United States, 2009-2010. NCHS Data Brief. 2013; (130):1–8.

26. de Souto Barreto P, Lapeyre-Mestre M, Vellas B, Rolland Y. Multimorbidity type, hospitalizations and emergency department visits among nursing home residents: A preliminary study. J Nutr Health Aging. 2014; 18(7):705–709. DOI: 10.1007/s12603-014-0504-6.

27. McGregor MJ, Abu-Laban RB, Ronald LA, McGrail KM, Andrusiek D, Baumbusch J, et al. Nursing home characteristics associated with resident transfers to emergency departments. Can J Aging. 2014; 33(1):38–48. DOI: 10.1017/S0714980813000615.

28. Lee CJ. Transfer from long term care agency/institution. In : Conference of the Korean Society of Emergency Medicine; 2014 April 17-18; Hotel Inter-Burgo EXCO. Daegu:

29. Dwyer R, Stoelwinder J, Gabbe B, Lowthian J. Unplanned transfer to emergency departments for frail elderly residents of aged care facilities: A review of patient and organizational factors. J Am Med Dir Assoc. 2015; 16(7):551–562. DOI: 10.1016/j.jamda.2015.03.007.