Purpose
As the rate of older people visiting Emergency Departments (EDs) increases, nurses are responsible for identifying patients at risk of poor outcomes and providing preventive interventions. The aim of this study was to identify the factors associated with the mortality of older adults hospitalized through EDs.
Methods
The study design was a retrospective correlational design using the electronic medical records from a tertiary hospital in Korea. Data were collected from January 3 to March 6, 2016 through the hospital information center based on elderly patients admitted from January 1, 2011 to August 31, 2015. The study variables included general and admission characterstics, disease characteristics, and mortality of older patients visiting EDs.
Results
Of the 9,896 patients, the mortality rate was 7.4%; highest in patients aged over 86 years, men, or those hospitalized from nursing homes. Older adults arriving by private ambulance were 2.36 times more likely to die than walk-ins, and 1.38 times more likely for those using the 119 government emergency ambulance. Older patients hospitalized for more than four weeks were 2.17 times more likely to die than those hospitalized for less than a week.
Conclusion
Based on the study findings ward nurses will be able to early detect older patients at risk of poor outcomes and make better clinical decisions to improve the quality of nursing care. Nurses can propose health policies such as stricter management of the private ambulance service and considering the most efficient length of hospital stay for older adults hospitalized through EDs.

Citations

• Mortality and its determinants among patients attending in emergency departments
  Mengistu Abebe Messelu, Baye Tsegaye Amlak, Gebrehiwot Berie Mekonnen, Asnake Gashaw Belayneh, Sosina Tamre, Ousman Adal, Tiruye Azene Demile, Yeshimebet Tamir Tsehay, Alamirew Enyew Belay, Henok Biresaw Netsere, Wubet Tazeb Wondie, Gebremeskel Kibret Abe
  BMC Emergency Medicine.2024;[Epub]     CrossRef
• Factors Associated with Return Visits by Elders within 72 Hours of Discharge from the Emergency Department
  Li-Hsiang Wang, Hui-Ling Lee, Chun-Chih Lin, Chia-Ju Lan, Pei-Ting Huang, Chin-Yen Han
  Healthcare.2023; 11(12): 1726.     CrossRef
• Retrospective Analysis of the Oldest-Old Patients Who Applied to the Emergency Department and Their Differences from the Young-Old And Middle-Old
  İbrahim TOKER, Ayşin KILINÇ TOKER, İrfan GÖKÇEK, Emre BULBUL, Gökhan YILMAZ, Mustafa SİLCAN, Şaban IRMAK, Mükerrem ALTUNTAŞ
  Anatolian Journal of Emergency Medicine.2023; 6(1): 20.     CrossRef
• Potentially Inappropriate Prescriptions to Older Patients in Emergency Departments in South Korea: A Retrospective Study
  Kyungim Kim, Jinyoung Jung, Haesook Kim, Jung Tae Kim, Jung Mi Oh, Hyunah Kim
  Therapeutics and Clinical Risk Management.2021; Volume 17: 173.     CrossRef

PURPOSE
The purpose of this study was to investigate the effect of geriatric syndrome on mortality among community-dwelling older adults in Korea.
METHODS
Data were obtained from the Actual Living Condition of the Elderly and Welfare Need Survey, with a baseline study in 2008 and a 3-year follow-up of mortality data. The mortality risk was measured using the hierarchical Cox proportional hazard model.
RESULTS
In Cox regression analysis, male (Hazard Ratio [HR], 2.53; 95% Confidence Interval [CI], 2.12~3.01), old age (HR, 2.14; 95% CI, 1.82~2.53), low education level (HR, 1.31; 95% CI, 1.04~1.65), limitation in instrumental activities of daily living (HR, 1.91; 95% CI, 1.60~2.28), depressive symptoms (HR, 1.21; 95% CI, 1.01~1.43), and frailty (HR, 2.32; 95% CI, 1.78~3.03) significantly affected mortality risk.
CONCLUSION
Based on the results of this study, nursing intervention programs should be provided to decrease preventable death in older adults.

Citations

• Factors Associated with Frailty According to Gender of Older Adults Living Alone
  Hye-Young Jang, Ji-Hye Kim
  Healthcare.2021; 9(4): 475.     CrossRef
• Factors contributing to the use of complementary and alternative medicine in rural older women with chronic pain in South Korea
  Saunjoo L. Yoon, Jeong-Hee Kim
  Applied Nursing Research.2013; 26(4): 186.     CrossRef

PURPOSE
The purpose of this study was to evaluate and compare the predictive ability of three mortality scoring systems; Acute Physiology and Chronic Health Evaluation(APACHE) III, Simplified Acute Physiology Score(SAPS) II, and Mortality Probability Model(MPM) II in discriminating in-hospital mortality for intensive care unit(ICU) patients with spontaneous intracerebral hemorrhage. METHODS: Eighty-nine patients admitted to the ICU at a university hospital in Daejeon Korea were recruited for this study. Medical records of the subject were reviewed by a researcher from January 1, 2003 to March 31, 2004, retrospectively. Data were analyzed using SAS 8.1. General characteristic of the subjects were analyzed for frequency and percentage. RESULTS: The results of this study were summarized as follows. The values of the Hosmer-Lemeshow's goodness-of-fit test for the APACHE III, the SAPS II and the MPM II were chi-square H=4.3849 p=0.7345, chi-square H= 15.4491 p=0.0307, and chi-square H=0.3356 p=0.8455, respectively. Thus, The calibration of the MPM II found to be the best scoring system, followed by APACHE III. For ROC curve analysis, the areas under the curves of APACHE III, SAPS II, and MPM II were 0.934, 0.918 and 0.813, respectively. Thus, the discrimination of three scoring systems were satisfactory. For two-by-two decision matrices with a decision criterion of 0.5, the correct classification of three scoring systems were good. CONCLUSION: Both the APACHE III and the MPM II had an excellent power of mortality prediction and discrimination for spontaneous intracerebral hemorrhage patients in ICU.

Using the APCHE III tool, this study was about the factors related to the death of ICU-patients. From 1999. 12. 1 to 2000. 9. 30, the 284 patients admitted to ICU at P university who were over 15 years of age were selected for the subjets. The data was analyzed through SPSS WIN program for frequency, percentile, x2-test, t-test and logistic regression. The results are summarized as follows: 1) Of the 284 patients, 88died. The mortality is 31.0 percent. The average APACHE III point was 48.62 +/- 32.32. The average point of non-survivors was higher than that of survivors. 2) There are the significant difference between APACHE III marks and mortality. The mortality rate were over 50 percent 60 points of the mark. When the marks were over 100 points, the mortality were over 90 percent. Below 40 points, the mortality was below 10 percent. Among the variables in the APACHE III, the most significant variables in explaining death were neurologic abnormalities, pulse, PaO2/ AaDO2, creatinine, sodium, glucose, chronic health state and age. According to the variables, the models explained the 42.43 percent of the variance in patient's death. In conclusion, the APACHE III tool can be used to predict the progress of ICU patients, and can also be used for the selection of patients for ICU admission/discharge criteria.