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Question
Background:
- With current medical advances and the adoption of healthier lifestyles, people are living longer.
- 65+ years old is the fastest growing segment of the global population
- In 1994:
- 65+ accounted for 13% of the population
- By 2030:
- Developed Countries: 65+ age segment of population will be larger than <65 age in many developed countries
- Developing Countries: 75% of elderly will be living in lower and middle income countries with less well-developed health care systems
Relevance to the EM Physician:
- Elderly account for 12% to 24% of all ED visits
- Older patients present with a higher level of acuity and generally have more serious medical illness.
- Arrive more often by ambulance
- Higher rates of test use and longer ED stays
- 2.5 to 4.6 times higher risk for hospitalization
- 5-fold higher admission rate to an ICU
- More likely to be misdiagnosed
- More frequently discharged with unrecognized / untreated problems.
Answer
Bottom Line:
- Emergency physicians and healthcare professionals practicing in acute care settings around the world will increasingly be relied upon to care for geriatric acute care patients.
- Focus should be placed on education of healthcare practitioners, protocols for targeting high-risk geriatric populations, and the creation of emergency departments with resources to care for the elderly
References
University of Maryland Section of Global Emergency Health Author: Terrence Mulligan DO, MPH
Samaras N, Chevalley T, Samaras D, et al. “Older Patients in the Emergency Department: A Review” Annals of EM Vol 56:3, Sept 2010, p 261-269.
WHO Global Burden of Disease. 2010. www.who.int/healthinfo/global_burden_disease/GBD_report_2010update_full.pdf
United Nations. “World Population Ageing 1950-2050” 2011. www.esa.un.org/wpp/