Impact of inter-visit duration on mortality in older adults who use emergency department frequently

The incidence of older adults presenting to the emergency department (ED) is increasing, and assessing their potential mortality risk for those returning frequently to the ED remains important. This study aims to evaluate the effects of frequent ED visits and the interval between these visits on the mortality of older adults.We retrospectively assessed the data of patients aged 65 years and above who frequently visited an academic ED in Turkey in 2021 and divided them into two groups: ED-frequent users (FUs) (4–7 visits) and ED-highly frequent users (HFUs) (>7 visits), following which we compared their characteristics, inter-visit duration, and 6-month mortality. The results indicated that out of the 2947 ED visits, 516 older adults were identified who visited the ED at least four times, averaging 5.7 visits per patient. HFUs constituted approximately 12% (n = 61)of the cohort. Further analysis revealed a significant increase in mortality associated with shorter inter-visit duration between ED visits (p < 0.001). Specifically, visiting the ED at intervals shorter than 74 days was associated with a fourfold increase in mortality risk (odds ratio (OR): 3.84; 95% confidence interval (CI): 2.64–5.57; p < 0.001), which escalated to sixfold in patients with a history of recent hospitalization (OR: 5.87; 95%CI: 3.81–9.07; p < 0.001).The data indicated that most older adults with frequent ED visits had multiple comorbidities, and those who did not survive were significantly older. This study highlights the important need to acknowledge the increased mortality risk among older adults with frequent ED visits, with recent hospitalization and short inter-visit duration being contributing factors.

Older adults; Elderly; Frequent user; Visit; Emergency department; Mortality

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