Re-presentations to the Emergency Department for older persons experiencing pain: A retrospective cohort study

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BACKGROUND: Pain is a leading reason for Emergency Department (ED) presentations among older adults, yet the prevalence and characteristics of pain-related 48-hours re-presentations remains unclear. METHODS: A retrospective analysis of ED presentations among patients aged ≥65 years was conducted. Descriptive statistics characterised the cohort, and univariable and multivariable logistic regression analyses identified factors associated with 48-hour re-presentation. RESULTS: Of 151,052 ED index patient visits, 44,334 were pain-related, and more than half (56.8%) re-presented for pain. Identified factors; regional areas inner (OR 1.4, 95% CI 1.2-1.6) and outer (OR 1.7, 95% CI 1.5-2.1), ambulance transfer (OR 1.2, 95% CI 1.1-1.3), musculoskeletal conditions (OR 4.1, 95% CI 3.3-5.0) or higher triage acuity (OR 2.7, 95% CI 2.1-3.6). However, patients aged ≥85 years (OR 0.77, 95% CI 0.66-0.91) and/or from aged care (OR 0.53, 95% CI 0.36-0.80) or community-based appointments (OR 0.71, 95% CI 0.54-0.93) had lower odds of re-presentation. CONCLUSIONS: This study identified groups potentially at higher risk highlighting the need for targeted pain management, structured follow-up, and improved access to community and specialist care to reduce recurrent visits.

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