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Öğe Epidemiology of geriatric patients presenting to emergency departments in Europe: EGERS study(Lippincott Williams & Wilkins, 2023) Karamercan, Mehmet A.; Dundar, Defne Z.; Slagman, Ana; Ergin, Mehmet; Janssens, Kelly Ann C.; Fabbri, Andrea; Bjornsen, Lars P.Background and importancePatients aged 65 and above constitute a large and growing part of emergency department (ED) visits in western countries. ObjectiveThe primary aim of this European prospective study was to determine the epidemiologic characteristics of elderly patients presenting to EDs across Europe. Our secondary objective was to determine the hospitalization rate, characteristics, and in-hospital mortality rates of geriatric patients presenting to EDs. Design setting and participantsAn observational prospective cohort study over seven consecutive days between 19 October and 30 November 2020, in 36 EDs from nine European countries. Patients aged 65 years and older presenting to EDs with any complaint during a period of seven consecutive days were included. Outcome measuresData were collected on demographics, the major presenting complaint, the presenting vital signs, comorbidities, usual medication, and outcomes after the ED, including disposition, in-hospital outcome, and the final hospital diagnosis. The patients were stratified into three groups: old (65-74 years), older (75-84 years), and oldest age (>85 years). Main resultsA total of 5767 patients were included in the study. The median age of the patients was 77 (interquartile range: 71-84) years. The majority presented with a non-traumatic complaint (81%) and about 90% of the patients had at least one comorbid disease and were on chronic medication. An ED visit resulted in subsequent hospital admission in 51% of cases, with 9% of patients admitted to an intensive care unit. Overall in-hospital mortality was 8%, and ED mortality was 1%. Older age was associated with a higher female proportion, comorbidities, need for home care service, history of previous falls, admission rates, length of ED, and hospital stay. ConclusionThe characteristics of ED elderly patients and their subsequent hospital stay are reported in this prospective study.Öğe Modified Early Warning Score and VitalPac Early Warning Score in geriatric patients admitted to emergency department(Lippincott Williams & Wilkins, 2016) Dundar, Zerrin Defne; Ergin, Mehmet; Karamercan, Mehmet A.; Ayranci, Kursat; Colak, Tamer; Tuncar, Alpay; Cander, BasarObjectiveThe aim of this study was to evaluate the value of the Modified Early Warning Score (MEWS) and the VitalPac Early Warning Score (VIEWS) in predicting hospitalization and in-hospital mortality in geriatric emergency department (ED) patients.Patients and methodsThis prospective, single-centered observational study was carried out over 1 month at the ED of a university hospital in patients 65 years of age and older presenting to the ED. The vital parameters of the patients measured on admission to ED were recorded. The MEWS and VIEWS were calculated using the recorded physiological parameters of the patients. Hospitalization and in-hospital mortality were used as the primary outcomes.ResultsA total of 671 patients included in the study. The median age of the patients was 75 (11) years, and 375 (55.9%) were men. The MEWS is effective for discriminating patient groups that have been discharged from ED, admitted to a ward and admitted to ICU [1 (2) vs. 1 (1) vs. 3 (3), respectively, P<0.001]. The VIEWS is also effective for discriminating patient groups that have been discharged from ED, admitted to a ward, and admitted to ICU [2 (3) vs. 5 (5) vs. 8 (8), respectively, P<0.001]. The AUCs of the MEWS and VIEWS were 0.727 [95% confidence interval (CI) 0.689-0.765] and 0.756 (95% CI 0.720-0.792) in predicting hospitalization, respectively. The AUCs of the MEWS and VIEWS were 0.891 (95% CI 0.844-0.937) and 0.900 (95% CI 0.860-0.941) in predicting in-hospital mortality, respectively.ConclusionThe MEWS and VIEWS are powerful scoring systems that are easy-to-use for predicting the hospitalization and in-hospital mortality of geriatric ED patients.Öğe Response to 'Identifying needs of older patients at the emergency department'(Lippincott Williams & Wilkins, 2023) Karamercan, Mehmet A.; Dundar, Defne Z.[Abstract Not Availabe]
