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HOME > J Korean Acad Community Health Nurs > Volume 27(4); 2016 > Article
Original Article
Characteristics and Mortality Risk Factors in Geriatric Hospital Patients visiting One Region-wide Emergency Department
Kyoung Wan Kim, Soongnang Jang
Journal of Korean Academy of Community Health Nursing 2016;27(4):327-336.
DOI: https://doi.org/10.12799/jkachn.2016.27.4.327
Published online: December 31, 2016

1The Catholic University of Korea Uijeongbu St. Mary's Hospital, Uijeongbu, Korea.

2Red Cross College of Nursing, Chung-Ang University, Seoul, Korea.

• Received: May 18, 2016   • Revised: November 14, 2016   • Accepted: November 14, 2016

© 2016 Korean Academy of Community Health Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Purpose
    This study was to examine the clinical characteristics and mortality risk factors of geriatric hospital patients who visited one region-wide emergency department (ED). It's basically meant to develop criteria for the patient management of geriatric hospitals and to provide related information.
  • Methods
    A retrospective research study was implemented using electronic medical records. The subjects in this study included 484 geriatric hospital patients who were selected from among 15,994 patients that visited one region-wide ED between January 1, 2014, and December 31, 2015.
  • Results
    There were significant differences in death, a change for the better and no change for the better, which were results of treatment, according to the length of stay in hospital, hospitalization in a general ward, not having an operation or surgery, the presence or absence of malignant neoplasm, the insertion of foley catheter, intubation, ventilator and the insertion of central venous catheter.
  • Conclusion
    The results of this study suggest that a patient management system is necessary in geriatric hospitals and that competent healthcare workers who can properly respond to emergencies are required as well.
  • Key Words: Length of stay; Hospital; Mortality; Emergency department
Table 1

General Characteristics (N=484)

Characteristics Categories n (%)
Gender Female 251 (51.9)
Male 233 (48.1)
Age (year) <50 21 (4.3)
50~59 42 (8.7)
60~69 83 (17.1)
70~79 184 (38.0)
≥80 154 (31.8)
Pain (NRS) None 248 (51.2)
NRS1~2 146 (30.2)
≥NRS3 90 (18.6)
Length of stay for geriatrics (LOS: days) ≤25.0 164 (33.9)
26.0~172.0 159 (32.8)
≥173.0 161 (33.3)
Type of admission General ward 199 (41.1)
ICU 67 (13.8)
Discharge 218 (45.0)
Sore No 371 (77.0)
Yes 111 (22.9)
Length of stay for hospital (days) ≤1.0 219 (45.3)
2.0~9.0 113 (23.4)
≥10.0 152 (31.4)
Outcome Died 51 (10.5)
Improved 342 (70.7)
Not improved 89 (18.4)
Table 2

Reason for Transfer (N=484)

Variables n (%)
Dyspnea 78 (16.1)
Fever 46 (9.5)
Abdominal discomfort 42 (8.7)
Decreased mentality 38 (7.9)
For blood transfusion 28 (5.8)
Musculoskeletal problem 28 (5.8)
Hematochezia 27 (5.6)
Visual disturbance 21 (4.3)
General weakness 20 (4.1)
Hematemesis 19 (3.9)
Chest discomfort 17 (3.5)
Hypotension 13 (2.7)
Hematuria, gross 12 (2.5)
AVF operation 11 (2.3)
Seizure 11 (2.3)
CRF 11 (2.3)
Concussion 8 (1.7)
Vaginal bleeding 8 (1.7)
Dizziness 7 (1.4)
Cough 6 (1.2)
Pneumonia 6 (1.2)
Dysarthria 5 (1.0)
Pain 5 (1.0)
Dysuria 4 (0.8)
Vomiting 4 (0.8)
Diarrhea 4 (0.8)
Dyspepsia 3 (0.6)
Poor oral intake 2 (0.4)
Table 3

Clinical Characteristics (N=484)

Characteristics Categories n (%)
HTN No 163 (33.7)
Yes 321 (66.3)
DM No 294 (60.7)
Yes 190 (39.3)
Tuberculosis No 471 (97.3)
Yes 13 (2.7)
Hepatitis No 470 (97.1)
Yes 14 (2.9)
Heart disease No 392 (81.0)
Yes 90 (18.6)
Cerebral disease No 213 (44.0)
Yes 271 (56.0)
Respiratory Disease No 448 (92.6)
Yes 36 (7.4)
Genitourinary disease No 399 (82.4)
Yes 85 (17.6)
Neoplasm No 419 (86.6)
Yes 65 (13.4)
other disease No 394 (81.4)
Yes 90 (18.6)
Triage Level 1~2 14 (2.9)
3 148 (30.6)
4~5 306 (63.2)
Antibiotics use in the geriatric hospital No 339 (70.0)
Yes 134 (27.7)
Foley catheter No 223 (46.1)
Yes 260 (53.7)
Endo-tracheal tube No 429 (88.6)
Yes 54 (11.2)
Ventilator No 443 (91.5)
Yes 40 (8.3)
Central line No 376 (77.7)
Yes 107 (22.1)
Tracheotomy No 430 (88.8)
Yes 53 (11.0)
Operation No 450 (93.0)
Yes 34 (7.0)
Procedure No 308 (63.6)
Yes 176 (36.4)
Ex-infection (n=185, 38.2%) PNEU No 379 (78.1)
Yes 105 (21.7)
BSI No 453 (93.4)
Yes 29 (6.0)
UTI No 437 (90.3)
Yes 46 (9.5)
Mental status (AVPU) Alert 369 (76.2)
Verbal response 43 (8.9)
Painful response 57 (11.8)
Unresponsiveness 15 (3.1)
Antibiotics treatment on the ED No 180 (37.2)
Yes 304 (62.8)

HTN=hypertension; DM=diabetes mellitus; Ex-infection=Infection in the geriatric hospital; PNEU=pneumonia; BSI=blood stream infection; UTI=urinary track infection; ED=emergency department.

Table 4

Clinical Characteristics & Outcome (N=484)

Characteristics Categories Died (n=51) Improved (n=342) Not improved (n=89) x2 p
n (%) n (%) n (%)
Gender Female 27 (10.8) 181 (72.4) 42 (16.8) 0.95 .620
Male 24 (10.3) 161 (69.4) 47 (20.3)
Triage level Not known 0 (0.0) 2 (66.7) 1 (1.1) 13.42 .037
1~2 24 (14.9) 98 (60.9) 39 (33.3)
3 26 (8.5) 231 (75.7) 48 (15.7)
4~5 1 (7.7) 11 (84.6) 1 (7.7)
Hospital LOS (days) ≤1.0 21 (9.7) 125 (57.6) 71 (32.7) 54.25 ＜.001
2.0~9.0 13 (11.5) 90 (79.7) 10 (8.9)
≥10.0 17 (11.2) 127 (83.6) 8 (5.3)
Type of admission General ward 21 (10.6) 167 (83.9) 11 (5.5) 6.78 .034
Intensive care unit 11 (16.4) 47 (70.2) 9 (13.4)
Mental status (AVPU) Alert 34 (9.2) 271 (73.6) 63 (17.1) 27.32 ＜.001
Verbal response 3 (6.98) 29 (67.4) 11 (25.6)
Painful response 7 (12.3) 37 (64.9) 13 (22.8)
Unresponsiveness 7 (50.0) 5 (35.7) 2 (14.3)
Operation No 48 (10.7) 311 (69.4) 89 (19.9) 8.93 .012
Yes 3 (8.8) 31 (91.2) 0 (0.0)
Procedure No 27 (8.8) 207 (67.7) 72 (23.5) 15.38 ＜.001
Yes 24 (13.6) 135 (76.7) 17 (9.7)
DM No 25 (8.5) 212 (72.1) 57 (19.4) 3.56 .168
Yes 26 (13.8) 130 (69.2) 32 (17.0)
HTN No 20 (12.3) 115 (70.6) 28 (17.2) 0.89 .641
Yes 31 (9.7) 227 (71.2) 61 (19.1)
Neoplasm No 37 (8.9) 301 (72.2) 79 (18.9) 9.57 .008
Yes 14 (21.5) 41 (63.1) 10 (15.4)
F-cath None 10 (4.5) 163 (73.4) 49 (22.1) 20.33 ＜.001
Ex-insertion 15 (12.0) 88 (70.4) 22 (17.6)
ED insertion 25 (18.7) 91 (67.9) 18 (13.4)
Endo-tracheal tube None 31 (7.2) 319 (74.5) 78 (18.2) 44.56 ＜.001
Ex-insertion 3 (33.3) 5 (55.6) 1 (11.1)
ED insertion 16 (36.4) 18 (40.9) 10 (22.7)
Tracheotomy None 44 (10.3) 299 (69.9) 85 (19.9) 15.80 .015
Ex-insertion 2 (6.1) 28 (84.8) 3 (9.1)
ED insertion 4 (20.0) 15 (75.0) 1 (5.0)
Ventilator None 34 (7.7) 325 (73.5) 83 (18.8) 46.54 ＜.001
Ex-insertion 2 (66.7) 0 (0.0) 1 (33.3)
ED insertion 14 (38.9) 17 (47.2) 5 (13.9)
Central line None 25 (6.7) 276 (73.8) 73 (19.5) 26.83 ＜.001
Ex-insertion 4 (16.0) 17 (68.0) 4 (16.0)
ED insertion 21 (25.6) 49 (59.8) 12 (14.6)
Antibiotics No 11 (61.2) 128 (71.5) 40 (22.4) 7.63 .022
Yes 40 (13.2) 214 (70.6) 49 (16.2)
Type of discharge Died 51 (100.0) 0 (0.0) 0 (0.0) 516.74 ＜.001
Transfer 0 (0.0) 214 (72.8) 80 (27.2)
Go to home 0 (0.0) 127 (94.8) 7 (5.2)
Others 0 (0.0) 1 (33.3) 2 (66.7)

DM=diabetes mellitus; HTN=hypertension; Ex-insertion=inserted in the geriatric hospital; ED-insertion=inserted in the emergency department.

Table 5

Geriatric Hospital Patients Mortality Risk Factor in Visiting Emergency Department (N=484)

Variables Categories B SE Wals DF p OR 95% CI
Min Max
Gender Female Ref 0.52 0.43 1 .513 0.71 0.26 1.97
Male −0.34
Age 0.35 0.28 1.67 1 .197 1.43 0.83 2.44
Hospital LOS −0.83 0.49 2.85 1 .092 0.44 0.17 1.14
G Hospital LOS −0.23 0.32 0.54 1 .463 0.79 0.42 1.48
TRIAGE 0.07 0.50 0.02 1 .889 1.07 0.40 2.85
Mental status (AVPU) 0.61 3 .894
 Alert Ref
 Verbal response −0.45 0.86 0.27 1 .602 0.64 0.12 3.46
 Painful response −0.42 0.73 0.32 1 .570 0.66 0.16 2.77
 Unresponsiveness 0.37 1.49 0.06 1 .806 1.44 0.08 26.70
Antibiotics No Ref
Yes −0.24 0.83 0.08 1 .771 0.79 0.15 4.00
Ex-infection No Ref 0.52 0.23 1 .633 1.28 0.46 3.56
Yes 0.25
Operation No Ref -015
Yes 0.79 0.03 1 .853 0.86 0.18 4.08
Neoplasm No Ref
Yes 1.74 0.59 8.75 1 .003 5.69 1.80 17.99
Foley catheter No Ref
Yes 1.88 0.86 4.74 1 .030 6.54 1.21 35.48
Endotracheal tube No Ref
Yes 1.39 0.86 2.59 1 .107 4.01 0.74 21.70
Ventilator No Ref
Yes 1.36 0.92 2.19 1 .139 3.91 0.64 23.83
Central line No Ref
Yes 1.81 0.54 11.03 1 .001 6.08 2.10 17.65
Tracheotomy No Ref
Yes −0.92 0.71 1.65 1 .199 0.40 0.10 1.62

OR=odds ratio; CI=confidence intervals; LOS=length of stay; GW=general ward; ICU=intensive care unit.

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