Overnight Stay in Emergency Department Increases Risk of Death in Elderly Patients – Online International News Network ReadingS


ISLAMABAD (ONLINE): Elderly people who spend the night in emergency rooms due to a shortage of hospital beds are more likely to die or develop new health problems during their stay, according to a major new study.

The French researchers’ findings were published this month in the journal JAMA Internal Medicine. The analysis included 1,598 people age 75 and older who went to emergency rooms and stayed there overnight while waiting to be hospitalized. The average age of the people participating in the study was 86 years old. The researchers compared the results for two groups: those who stayed in the emergency room from midnight to 8 a.m. and those who were admitted to the hospital before midnight.

Co-author Yonathan Freund, MD, PhD, called the study period in December 2022 a “strange time” because Europe, like the United States, was going through a triple pandemic of influenza, COVID-19, and respiratory syncytial virus (RSV). According to a podcast interview published alongside the study results.

“There were a lot of elderly patients who needed hospital beds, and of course there were not enough,” said Freund, a general physician in Paris and a professor at France’s Sorbonne University.

The analysis showed that people who spent the night in the emergency room died during their hospital stay at a 40% higher rate than people who were admitted to the room before midnight. While the mortality rate was 15.7 percent for those who stayed one night in the emergency room, this rate was 11.1 percent for those who found a room before midnight.

The increased mortality rate during a hospital stay after an overnight emergency room stay was particularly higher among people who were not fully independent, meaning they needed assistance with activities of daily living.

People who spent the night in the emergency room had higher rates of other health problems during their hospital stay compared to people who were admitted before midnight. Overnight emergency room stays were associated with a 24% increased risk of new health problems. New problems researchers looked for included falls, infections, bleeding, heart attacks, strokes, pressure ulcers and blood clots.

People who were unable to spend the night in the hospital and instead ended up in the emergency room were more likely to stay in the hospital longer than those admitted before the clock struck 12.

Before the COVID-19 pandemic, 90% of emergency rooms in the U.S. regularly reported overcrowding, with wait times averaging more than 2.5 hours in 2022, according to a commentary published with the study.

Comment authors Timothy S. Anderson, MD, MAS, of the University of Pittsburgh, and Shoshana J. Herzig, MD, MPH, of Harvard Medical School, wrote that the new findings point to several options for emergency departments and hospitals to make improvements.

They suggested creating new, less stressful sections in emergency departments and addressing staffing to monitor people waiting in emergency rooms who are thought to be in stable condition but are awaiting hospital admission. A third area to consider is staffing changes in hospitals, which can increase the flow of discharged people so that bed shortages can be reduced. Another option that could change the “exit” of patients is the use of “discharge halls” to evacuate rooms, they said.

news source (onlinenews.com.pk)


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