Emergency department outcome of elderly patients assisted by professional home services, the EPIGER study
Rattachement africain : ca, fr. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND: For the elderly population living at home, the implementation of professional services tends to mitigate the effect of loss of autonomy and increases their quality of life. While helping in avoiding social isolation, home services could also be associated to different healthcare pathways. For elderly patients, Emergency Departments (EDs) are the main entrance to hospital where previous loss of autonomy is associated to worst hospital outcomes. Part of elderly patients visiting EDs are still admitted to hospital for having difficulties coping at home without presenting any acute medical issue. There is a lack of data concerning elderly patients visiting EDs assisted by home services. Our aim was to compare among elderly patients visiting ED those assisted by professional home services to those who do not in terms of emergency resources' use and patients' outcome. METHODS: A multicenter, prospective cohort study was performed in 124 French EDs during a 24-h period on March 2016.Consecutive patients living at home aged ≥80 years were included. The primary objective was to assess the risk of mortality for patients assisted by professional home services vs. those who were not. Secondary objectives included admission rate and specific admission rate for "having difficulties coping at home". The primary endpoint was in-hospital mortality. Cox proportional-hazards regression model was used to test the association between professional home services and the primary endpoint. Multi variables logistic regressions were performed to assess secondary endpoints. RESULTS: One thousand one hundred sixty-eight patients were included, median age 86(83-89) years old,32% were assisted by professional home services. The overall in-hospital mortality rate was 7%. Assisted patients had more investigations performed. Home services were not associated with increased in-hospital mortality (HR = 1.34;95%CI [0.68-2.67]), nor with the admission rate (OR = 0.92;95%CI [0.65-1.30]). Assisted patients had a lower risk of being admitted for "having difficulties coping at home" (OR = 0.59;95%CI [0.38-0.92]). CONCLUSION: Professional home services which assist one-third of elderly patients visiting EDs, were not associated to lower in-hospital mortality or to an increased admission rate. Assisted patients were associated to a lower risk of being admitted for «having difficulties coping at home».Professional home services could result in avoiding some admissions and their corollary complications. TRIAL REGISTRATION: Clinicaltrial.gov - NCT02900391 , 09/14/2016, retrospectively registered.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Emergency department outcome of elderly patients assisted by professional home services, the EPIGER study
- Date Crossref
- 21/09/2020
- Éditeur
- Springer Science and Business Media LLC
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Université de Sherbrooke CR-CSIS pays non établi dans la noticeUniversité ou école supérieure
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Assistance Publique – Hôpitaux de Paris pays non établi dans la noticeÉtablissement de santé
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Hôpital Européen Georges-Pompidou pays non établi dans la noticeÉtablissement de santé
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Centre de recherche Charles-Le Moyne pays non établi dans la noticeÉtablissement de santé
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Hôpital Saint-Antoine pays non établi dans la noticeÉtablissement de santé
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Hôpital Charles-Nicolle pays non établi dans la noticeÉtablissement de santé
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Université de Tours pays non établi dans la noticeUniversité ou école supérieure
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Centre Hospitalier Universitaire de Tours pays non établi dans la noticeÉtablissement de santé
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Centre Hospitalier de Valenciennes pays non établi dans la noticeÉtablissement de santé
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Institut d'Etudes Politiques de Paris pays non établi dans la noticeStructure de recherche
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Hôpital Raymond-Poincaré pays non établi dans la noticeÉtablissement de santé
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Sorbonne Université pays non établi dans la noticeUniversité ou école supérieure
CR-CSIS — Université de Sherbrooke, Assistance Publique – Hôpitaux de Paris et Hôpital Européen Georges-Pompidou, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.