1. Influence of type of household on prognosis at one year in patients ≥65 years attending hospital emergency departments in Spain. The EDEN-6 study.
- Author
-
Alquézar-Arbé, Aitor, Osorio, Gina I., Jacob, Javier, García-Lamberechts, Eric Jorge, Piñera Salmerón, Pascual, Llorens, Pere, Burillo-Putze, Guillermo, Requena, Angela Cobos, Gil, Adriana, Fernández, Cesáreo, Aguiló, Sira, Jiménez, Sònia, Escudero Blázquez, Beatriz, Rosendo Mesino, Diana, Mojarro, Enrique Martín, Vaswani-Bulchand, Aarati, Rodríguez-Cabrera, Montserrat, Alarcón Martínez, Pedro, Gioya, Gema Dominguez, and Alemany González, Francesc Xavier
- Subjects
- *
HOSPITAL emergency services , *LIVING alone , *CAREGIVERS , *OLDER patients , *NURSING care facilities - Abstract
• The type of household is associated with elderly patients' prognosis at one year. • Living in a nursing home is associated with higher mortality. • Living at home but not alone is associated with a lower rate of rehospitalization/revisit. To investigate whether the type of household is associated with prognosis at one year in patients ≥65 years of age discharged after medical consultation requiring emergency department care. Data from the Emergency Department and Elder Needs (EDEN) cohort were used. This retrospective cohort included all patients ≥65 years of age seen in 52 Spanish emergency departments over one week (April 1–7, 2019) in whom the type of household was recorded and categorized as living at home alone, with relatives, with professional caregivers, or in a nursing home. Patient demographic and other baseline characteristics and management during the index emergency department episode were recorded and used to adjust the following 1-year outcomes: all-cause mortality, hospitalization and emergency department revisit. Associations between type of household and outcomes are expressed as adjusted hazard ratios with 95% confidence intervals using living alone as the reference category. 13,442 patients with a median age of 79 years (interquartile range 72–86) were included; 56% were women, 12.2% of patients lived alone, 74.9% with relatives, 3.9% with a professional caregiver, and 9.1% in a nursing home. During the year following discharge, the mortality rate was 14.0%, the hospitalization rate 29.7%, and the emergency department revisit rate 59.3%. In the fully adjusted model, the risk of death was associated only with living in a nursing home (hazard ratio 1.366 (1.101–1.695)). On the other hand, the risk of hospitalization was lower in individuals living in nursing homes (hazard ratio 0.783 [0.676–0.907]) and at home with relatives (hazard ratio 0.897 [0.810–0.992]), while the risk of emergency department revisit was lower in individuals living in nursing homes (hazard ratio 0.826 [0.742–0.920]) or at home with caregivers (hazard ratio 0.856 [0.750–0.976]). The type of household was modestly associated with the one-year prognosis of patients ≥65 years of age discharged after attendance at an emergency department. Living in a nursing home is associated with an increased risk of death but a decreased risk of rehospitalization or emergency department revisit, while living at home with relatives or professional caregivers is associated only with a decreased risk of hospitalization and emergency department revisit, respectively. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF