Patients older than 60 years admitted to an emergency ward. A prospective study of one thousand twelve medical records.

Patients aged 60 years and older who were admitted to the emergency ward of the Edouard Herriot Hospital in Lyon were studied prospectively. These patients accounted for 40% of all admissions. Slightly over half were women (56%), and mean age was 78 years. Forty per cent lived alone, 83% were sent to the hospital by their physician, and 33% had cardiovascular disease. Factors that influenced destination on leaving the emergency ward were age, degree of dependency, and medical conditions: 78% of patients went to a short-stay medical ward, 16% returned to their home, and 6% died at the hospital. Mean hospital stay duration was 2.6 days. Factors associated with substantially longer hospital stay durations were advanced age, psychological dependence, a number of specific diagnoses, immediate referral by the emergency room to a medium- or long-term care department, and a need for special arrangements to be made in order that the patient may be discharged home. Aggregation of these factors defined a subset of very elderly patients, of whom many had dementia or Parkinson's disease. Long-term care facilities were unlikely to accept patients from the emergency room (one of 238 requests accepted).