UMEM Educational Pearls

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/