• Emergencias · Dec 2022

    Sociodemographic characteristics, comorbidity, and baseline functional status of older patients treated in emergency departments during the COVID-19 pandemic and associations with mortality: an analysis based on the EDENCOVID cohort.

    • Juan González Del Castillo, Javier Jacob, Eric Jorge García-Lamberechts, Pascual Piñera Salmerón, Aitor Alquézar-Arbé, Pere Llorens, Sònia Jiménez, Francisco de Borja Quero Espinosa, Sira Aguiló, Adriana Gil-Rodrigo, Cesáreo Fernández Alonso, Guillermo Burillo-Putze, Begoña Espinosa Fernández, Coral Suero Méndez, Marta Iglesias Vela, Eva Quero Motto, Jeong-Uh Hong Cho, Ferran Llopis, Rafael Marrón, Sara Gayoso Martín, Carmen Lucena Aguilera, Xavier Alemany González, RizziMiguel AMAServicio de Urgencias, Hospital de la Santa Creu i Sant Pau, Barcelona, España., Lluís Llauger, Ana Murcia Olagüenaga, Aarati Vaswani-Bulchand, Patricia Parra Esquivel, José Andrés Sánchez Nicolás, Elena Carrasco Fernández, Esther Ruescas Escolano, Chacón GarcíaAnaAServicio de Urgencias, Hospital Clínico San Carlos, IDISSC, Universidad Complutense, Madrid, España., Fátima Fernández Salgado, Òscar Miró, and Red de investigación SIESTA.
    • Servicio de Urgencias, Hospital Clínico San Carlos, IDISSC, Universidad Complutense, Madrid, España.
    • Emergencias. 2022 Dec 1; 34 (6): 428436428-436.

    ObjectivesTo describe the sociodemographic characteristics, comorbidity, and baseline functional status of patients aged 65 or older who came to hospital emergency departments (EDs) during the first wave of the COVID-19 pandemic, and to compare them with the findings for an earlier period to analyze factors of the index episode that were related to mortality.Material And MethodsWe studied data from the EDEN-COVID cohort (Emergency Department and Elder Needs During COVID-19) of patients aged 65 years or older treated in 40 Spanish EDs on 7 consecutive days. Nine sociodemographic variables, 18 comorbidities, and 7 function variables were registered and compared with the findings for the EDEN cohort of patients included with the same criteria and treated a year earlier in the same EDs. In-hospital mortality was calculated in the 2 cohorts and a multivariable logistic regression model was used to explore associated factors.ResultsThe EDEN-COVID cohort included 6806 patients with a median age of 78 years; 49% were women. The pandemic cohort had a higher proportion of men, patients covered by the national health care system, patients brought from residential facilities, and patients who arrived in an ambulance equipped for advanced life support. Pandemic-cohort patients more often had diabetes mellitus, chronic kidney disease, and dementia; they less often had connective tissue and thromboembolic diseases. The Barthel and Charlson indices were worse in this period, and cognitive decline was more common. Fewer patients had a history of depression or falls. Eight hundred ninety these patients (13.1%) died, 122 of them in the ED (1.8%); these percentages were lower in the earlier EDEN cohort, at 3.1% and 0.5%, respectively. Independent sociodemographic factors associated with higher mortality were transport by ambulance, older age, male sex, and living in a residential facility. Mortalityassociated comorbidities were neoplasms, chronic kidney disease, and heart failure. The only function variable associated with mortality was the inability to walk independently. A history of falls in the past 6 months was a protective factor.ConclusionThe sociodemographic characteristics, comorbidity, and functional status of patients aged 65 years or older who were treated in hospital EDs during the pandemic differed in many ways from those usually seen in this older-age population. Mortality was higher than in the prepandemic period. Certain sociodemographic, comorbidity, and function variables were associated with in-hospital mortality.

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