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- Title
Estudio EDEN-7: impacto de la pandemia COVID-19 sobre la demanda asistencial de personas mayores en los servicios de urgencias españoles.
- Authors
Montero-Pérez, F. Javier; Cobos Requena, Ángela María; González del Castillo, Juan; Jacob, Javier; García-Lamberechts, Eric Jorge; Piñera Salmerón, Pascual; Alquézar-Arbé, Aitor; Aguiló, Sira; Fernández Alonso, Cesáreo; Burillo-Putze, Guillermo; Calderón Caro, María; Díaz Salado, Ángel Iván; Mojarro, Enrique Martín; Eiroa-Hernández, Patricia; Parra-Esquivel, Patricia; López Pérez, Juan José; Ruiz Grinspan, Martín; Osorio Quispe, Ivet Gina; González Tejera, Matilde; Serrano Lázaro, Leticia
- Abstract
Objective. To analyze the impact of the COVID-19 pandemic on Spanish emergency department (ED) care for patients aged 65 years or older during the first wave vs. a pre-pandemic period. Methods. Retrospective cross-sectional study of a COVID-19 portion of the EDEN project (Emergency Department and Elder Needs). The EDEN-COVID cohort included all patients aged 65 years or more who were treated in 52 EDs on 7 consecutive days early in the pandemic. We analyzed care variables, discharge diagnoses, use of diagnostic and therapeutic resources, use of observation units, need for hospitalization, rehospitalization, and mortality. These data were compared with data for an EDEN cohort in the same age group recruited during a similar period the year before the pandemic. Results. The 52 participating hospital EDs attended 33 711 emergencies during the pandemic vs. 96 173 emergencies in the pre-COVID period, representing a 61.7% reduction during the pandemic. Patients aged 65 years or older accounted for 28.8% of the caseload during the COVID-19 period and 26.4% of the earlier cohort (P < .001). The COVID-19 caseload included more men (51.0%). Comorbidity and polypharmacy were more prevalent in the pandemic cohort than in the earlier one (comorbidity, 92.6% vs. 91.6%; polypharmacy, 65.2% vs. 63.6%). More resources (analgesics, antibiotics, heparins, bronchodilators, and corticosteroids) were applied in the pandemic period, and common diagnoses were made less often. Observation wards were used more often (for 37.8% vs. 26.2% in the earlier period), and hospital admissions were more frequent (in 56.0% vs. 25.3% before the pandemic). Mortality was higher during the pandemic than in the earlier cohort either in ED (1.8% vs 0.5%) and during hospitalization (11.5 vs 2.9%). Conclusions. The proportion of patients aged 65 years or older decreased in the participating Spanish EDs. However, more resources were required and the pattern of diagnoses changed. Observation ward stays were longer, and admissions and mortality increased over the numbers seen in the reference period.
- Subjects
SPAIN; HOSPITAL emergency services; CROSS-sectional method; MORTALITY; POLYPHARMACY; GERIATRICS; RETROSPECTIVE studies; PATIENT readmissions; EMERGENCY medical services; HOSPITAL care; DESCRIPTIVE statistics; COVID-19 pandemic; COMORBIDITY
- Publication
Emergencias, 2023, Vol 35, Issue 4, p270
- ISSN
1137-6821
- Publication type
Article