1
40
7
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1016/j.jamda.2006.05.009" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.jamda.2006.05.009</a>
Pages
105–109
Issue
2
Volume
8
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
The effect of a 12-month longitudinal long-term care rotation on knowledge and attitudes of internal medicine residents about geriatrics.
Publisher
An entity responsible for making the resource available
Journal of the American Medical Directors Association
Date
A point or period of time associated with an event in the lifecycle of the resource
2007
2007-02
Subject
The topic of the resource
Ohio; Aged; Curriculum; Prospective Studies; Attitude of Health Personnel; Educational Measurement; Clinical Competence; Education; Internship and Residency; Geriatric Assessment; Nursing Homes; Confidence Intervals; Internal Medicine; Human; Questionnaires; P-Value; Scales; Data Analysis Software; Pretest-Posttest Design; Professional Knowledge; Summated Rating Scaling; Interns and Residents; Internal Consistency; Attitude Measures; Wilcoxon Signed Rank Test; Paired T-Tests; Medical; Geriatrics – Education; Long Term Care – Education; Terminal Care – Education
Creator
An entity primarily responsible for making the resource
Baum EE; Nelson KM
Description
An account of the resource
OBJECTIVE: To determine if participation in a 12-month longitudinal long-term care (LTC) rotation resulted in improved knowledge and attitudes about geriatrics. DESIGN: Longitudinal study with paired measurements. SETTING: A community LTC facility and a university-affiliated, community-based internal medicine residency program. PARTICIPANTS: Sixty-seven internal medicine residents who participated in the rotation from 1997 through 2004. INTERVENTION: The internal medicine residents attended nursing home (NH) rounds one half day per month for 1 year, during which time they participated in a case-based interactive lecture on a core geriatric topic and rounded on their assigned patients. MEASUREMENTS: Knowledge was assessed using a 70-item test. Attitudes were evaluated with a 28-item, 5-point Likert scale (1 = least positive, 5 = most positive). RESULTS: The percent correct responses on geriatric knowledge pretest was 47% (95% CI = 45.2% to 48.8%) and on the posttest it was 57.5% (95% CI = 55.3% to 59.6%) (t = 8.180, df = 67, P \textless .001). The pretest total attitude score was 3.6 (95% CI = 3.6 to 3.7), with a posttest score of 3.7 (95% CI = 3.7 to 3.8) (P \textless .001). The difference in this total was accounted for mainly by the significant changes in the attitude subscales in educational preparation (pretest 3.6 [95% CI = 3.5 to 3.8]; posttest 3.8 [95% CI = 3.7 to 3.9] [P \textless .001]), general attitudes (pretest 4.0 [95% CI = 3.9 to 4.1]; posttest 4.2 [95% CI = 4.0 to 4.3] [P = .006]), and therapeutic potential (pretest 3.7 [95% CI = 3.5 to 3.8]; posttest 3.8 [95% CI = 3.7 to 3.9] [P = .048]). CONCLUSION: A longitudinal LTC rotation is an efficient and effective way to systematically provide internal medicine residents their core knowledge and experience in geriatrics.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/j.jamda.2006.05.009" target="_blank" rel="noreferrer noopener">10.1016/j.jamda.2006.05.009</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
2007
Aged
Attitude Measures
Attitude of Health Personnel
Baum EE
Clinical Competence
Confidence Intervals
Curriculum
Data Analysis Software
Education
Educational Measurement
Geriatric Assessment
Geriatrics – Education
Human
Internal Consistency
Internal Medicine
Interns and Residents
Internship and Residency
Journal of the American Medical Directors Association
Long Term Care – Education
Medical
Nelson KM
Nursing Homes
Ohio
P-Value
Paired T-Tests
Pretest-Posttest Design
Professional Knowledge
Prospective Studies
Questionnaires
Scales
Summated Rating Scaling
Terminal Care – Education
Wilcoxon Signed Rank Test
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1016/j.jamda.2006.05.009" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/j.jamda.2006.05.009</a>
Pages
105–109
Issue
2
Volume
8
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
The effect of a 12-month longitudinal long-term care rotation on knowledge and attitudes of internal medicine residents about geriatrics.
Publisher
An entity responsible for making the resource available
Journal of the American Medical Directors Association
Date
A point or period of time associated with an event in the lifecycle of the resource
2007
2007-02
Subject
The topic of the resource
*Attitude of Health Personnel; Aged; Attitudes; Clinical Competence/*standards; Cost-Benefit Analysis; Curriculum; Education; Educational Measurement; Efficiency; Geriatric Assessment; Geriatrics/*education; Graduate/organization & administration; Guidelines as Topic; Health Knowledge; Health Services Needs and Demand; Humans; Internal Medicine/*education; Internship and Residency/*organization & administration; Long-Term Care/*organization & administration; Longitudinal Studies; Medical; Nursing Homes; Ohio; Organizational; Practice; Program Evaluation; Self Efficacy; Surveys and Questionnaires
Creator
An entity primarily responsible for making the resource
Baum Elizabeth E; Nelson Karl M
Description
An account of the resource
OBJECTIVE: To determine if participation in a 12-month longitudinal long-term care (LTC) rotation resulted in improved knowledge and attitudes about geriatrics. DESIGN: Longitudinal study with paired measurements. SETTING: A community LTC facility and a university-affiliated, community-based internal medicine residency program. PARTICIPANTS: Sixty-seven internal medicine residents who participated in the rotation from 1997 through 2004. INTERVENTION: The internal medicine residents attended nursing home (NH) rounds one half day per month for 1 year, during which time they participated in a case-based interactive lecture on a core geriatric topic and rounded on their assigned patients. MEASUREMENTS: Knowledge was assessed using a 70-item test. Attitudes were evaluated with a 28-item, 5-point Likert scale (1 = least positive, 5 = most positive). RESULTS: The percent correct responses on geriatric knowledge pretest was 47% (95% CI = 45.2% to 48.8%) and on the posttest it was 57.5% (95% CI = 55.3% to 59.6%) (t = 8.180, df = 67, P \textless .001). The pretest total attitude score was 3.6 (95% CI = 3.6 to 3.7), with a posttest score of 3.7 (95% CI = 3.7 to 3.8) (P \textless .001). The difference in this total was accounted for mainly by the significant changes in the attitude subscales in educational preparation (pretest 3.6 [95% CI = 3.5 to 3.8]; posttest 3.8 [95% CI = 3.7 to 3.9] [P \textless .001]), general attitudes (pretest 4.0 [95% CI = 3.9 to 4.1]; posttest 4.2 [95% CI = 4.0 to 4.3] [P = .006]), and therapeutic potential (pretest 3.7 [95% CI = 3.5 to 3.8]; posttest 3.8 [95% CI = 3.7 to 3.9] [P = .048]). CONCLUSION: A longitudinal LTC rotation is an efficient and effective way to systematically provide internal medicine residents their core knowledge and experience in geriatrics.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/j.jamda.2006.05.009" target="_blank" rel="noreferrer noopener">10.1016/j.jamda.2006.05.009</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
*Attitude of Health Personnel
2007
Aged
Attitudes
Baum Elizabeth E
Clinical Competence/*standards
Cost-Benefit Analysis
Curriculum
Education
Educational Measurement
Efficiency
Geriatric Assessment
Geriatrics/*education
Graduate/organization & administration
Guidelines as Topic
Health Knowledge
Health Services Needs and Demand
Humans
Internal Medicine/*education
Internship and Residency/*organization & administration
Journal of the American Medical Directors Association
Long-Term Care/*organization & administration
Longitudinal Studies
Medical
Nelson Karl M
Nursing Homes
Ohio
Organizational
Practice
Program Evaluation
Self Efficacy
Surveys and Questionnaires
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1016/s0196-0644(94)70319-1" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/s0196-0644(94)70319-1</a>
Pages
813–817
Issue
4
Volume
23
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Case finding for cognitive impairment in elderly emergency department patients.
Publisher
An entity responsible for making the resource available
Annals of emergency medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
1994
1994-04
Subject
The topic of the resource
*Emergency Service; 80 and over; Aged; Aged/*psychology; Cognition Disorders/*diagnosis; Confidence Intervals; Cross-Sectional Studies; Female; Frail Elderly/psychology; Geriatric Assessment; Hospital; Humans; Male; Memory Disorders/diagnosis; Odds Ratio; Orientation; Regression Analysis
Creator
An entity primarily responsible for making the resource
Gerson L W; Counsell S R; Fontanarosa P B; Smucker W D
Description
An account of the resource
STUDY OBJECTIVES: To determine the feasibility of a case-finding program for cognitive impairment in elderly emergency department patients, and to describe the prevalence of cognitive impairment in screened patients and identify factors associated with impairment. DESIGN: A three-month cross-sectional study. The six-item Orientation-Memory-Concentration (OMC) Test was administered to eligible patients. SETTING: Community teaching hospital with annual ED census of 69,000 adults. PARTICIPANTS: All patients 65 years of age and older physically able to communicate and without a prior diagnosis of dementia were eligible. Five hundred forty-seven of 958 patients (59%) were interviewed; only 95 (10%) refused. Other reasons for exclusion were too ill, 113 (12%); other (sleeping, privacy, repeat visits, incomplete forms), 99 (10%); known dementia, 59 (6%); and communication problems, 45 (5%). RESULTS: A mean time of 1.9 minutes (+/- 0.91 SD) was required to complete the test. One hundred eighty-three of 547 patients (33.5%) had scores that indicated at least moderate cognitive impairment. Logistic regression analyses identified two factors associated with impairment: age of more than 80 years (odds ratio, 3.68; 95% confidence interval, 2.21-6.14) and residence in a nursing home (odds ratio, 13.8; 95% confidence interval, 3.79-50.2). CONCLUSION: Screening for cognitive impairment in elderly ED patients using the OMC Test is feasible. There is a high prevalence of cognitive impairment in elderly ED patients, and the prevalence increases with age. Identification of cognitive impairment is important in the assessment of elderly ED patients and may affect clinical evaluation, patients' understanding of medical information, and compliance with discharge instructions.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/s0196-0644(94)70319-1" target="_blank" rel="noreferrer noopener">10.1016/s0196-0644(94)70319-1</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
*Emergency Service
1994
80 and over
Aged
Aged/*psychology
Annals of emergency medicine
Cognition Disorders/*diagnosis
Confidence Intervals
Counsell S R
Cross-Sectional Studies
Department of Family & Community Medicine
Female
Fontanarosa P B
Frail Elderly/psychology
Geriatric Assessment
Gerson L W
Hospital
Humans
Male
Memory Disorders/diagnosis
NEOMED College of Medicine
Odds Ratio
Orientation
Regression Analysis
Smucker W D
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1016/s0196-0644(94)70319-1" target="_blank" rel="noreferrer noopener">http://doi.org/10.1016/s0196-0644(94)70319-1</a>
Pages
813–817
Issue
4
Volume
23
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Case finding for cognitive impairment in elderly emergency department patients.
Publisher
An entity responsible for making the resource available
Annals of emergency medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
1994
1994-04
Subject
The topic of the resource
Female; Male; Aged; Odds Ratio; Geriatric Assessment; Academic Medical Centers; Confidence Intervals; Psychological Tests; Human; Cross Sectional Studies; Funding Source; Logistic Regression; Emergency Service; Psychophysiology; Gerontologic Care; 80 and Over; Cognition Disorders – Diagnosis – In Old Age; Cognition Disorders – Epidemiology; Frail Elderly – Psychosocial Factors; Memory Disorders – Diagnosis
Creator
An entity primarily responsible for making the resource
Gerson L W; Counsell S R; Fontanarosa P B; Smucker W D
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1016/s0196-0644(94)70319-1" target="_blank" rel="noreferrer noopener">10.1016/s0196-0644(94)70319-1</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
1994
80 and over
Academic Medical Centers
Aged
Annals of emergency medicine
Cognition Disorders – Diagnosis – In Old Age
Cognition Disorders – Epidemiology
Confidence Intervals
Counsell S R
Cross Sectional Studies
Department of Family & Community Medicine
Emergency Service
Female
Fontanarosa P B
Frail Elderly – Psychosocial Factors
Funding Source
Geriatric Assessment
Gerontologic Care
Gerson L W
Human
Logistic Regression
Male
Memory Disorders – Diagnosis
NEOMED College of Medicine
Odds Ratio
Psychological Tests
Psychophysiology
Smucker W D
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1111/j.1553-2712.2008.00158.x" target="_blank" rel="noreferrer noopener">http://doi.org/10.1111/j.1553-2712.2008.00158.x</a>
Pages
613–616
Issue
7
Volume
15
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
The Six-item Screener to Detect Cognitive Impairment in Older Emergency Department Patients.
Publisher
An entity responsible for making the resource available
Academic Emergency Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2008
2008-07
Subject
The topic of the resource
Female; Male; Aged; Sensitivity and Specificity; Prospective Studies; ROC Curve; Geriatric Assessment; Academic Medical Centers; Confidence Intervals; Psychological Tests; Human; Cross Sectional Studies; Emergency Service; Cognition Disorders – Diagnosis; Emergency Medicine – Equipment and Supplies
Creator
An entity primarily responsible for making the resource
Wilber S T; Carpenter CR; Hustey FM
Description
An account of the resource
BACKGROUND: Cognitive impairment due to delirium or dementia is common in older emergency department (ED) patients. To prevent errors, emergency physicians (EPs) should use brief, sensitive tests to evaluate older patient's mental status. Prior studies have shown that the Six-Item Screener (SIS) meets these criteria. OBJECTIVES: The goal was to verify the performance of the SIS in a large, multicenter sample of older ED patients. METHODS: A prospective, cross-sectional study was conducted in three urban academic medical center EDs. English-speaking ED patients \textgreater or = 65 years old were enrolled. Patients who received medications that could affect cognition, were too ill, were unable to cooperate, were previously enrolled, or refused to participate were excluded. Patients were administered either the SIS or the Mini-Mental State Examination (MMSE), followed by the other test 30 minutes later. An MMSE of 23 or less was the criterion standard for cognitive impairment; the SIS cutoff was 4 or less for cognitive impairment. Standard operator characteristics of diagnostic tests were calculated with 95% confidence intervals (CIs), and a receiver operating characteristic curve was plotted. RESULTS: The authors enrolled 352 subjects; 111 were cognitively impaired by MMSE (32%, 95% CI = 27% to 37%). The SIS was 63% sensitive (95% CI = 53% to 72%) and 81% specific (95% CI = 75% to 85%). The area under the receiver operating characteristic curve was 0.77 (95% CI = 0.72 to 0.83). CONCLUSIONS: The sensitivity of the SIS was lower than in prior studies. The reasons for this lower sensitivity are unclear. Further study is needed to clarify the ideal brief mental status test for ED use.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1111/j.1553-2712.2008.00158.x" target="_blank" rel="noreferrer noopener">10.1111/j.1553-2712.2008.00158.x</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
2008
Academic Emergency Medicine
Academic Medical Centers
Aged
Carpenter CR
Cognition Disorders – Diagnosis
Confidence Intervals
Cross Sectional Studies
Emergency Medicine – Equipment and Supplies
Emergency Service
Female
Geriatric Assessment
Human
Hustey FM
Male
Prospective Studies
Psychological Tests
ROC Curve
Sensitivity and Specificity
Wilber S T
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1111/j.1553-2712.2003.tb01999.x" target="_blank" rel="noreferrer noopener">http://doi.org/10.1111/j.1553-2712.2003.tb01999.x</a>
Pages
251–260
Issue
3
Volume
10
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
A research agenda for geriatric emergency medicine.
Publisher
An entity responsible for making the resource available
Academic Emergency Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2003
2003-03
Subject
The topic of the resource
Aged; Physicians; Health Services Research; Emergency Medicine; Geriatric Assessment; Emergency Service; Research Priorities; Health Resource Utilization; Prehospital Care; Trauma – Therapy – In Old Age; Emergency Care – In Old Age; Emergency – Education
Creator
An entity primarily responsible for making the resource
Wilber S T; Gerson L W
Description
An account of the resource
OBJECTIVES: The Research Agenda Setting Process (RASP), part of the American Geriatric Society's (AGS's) project 'Increasing Geriatric Expertise in Surgical and Related Medical Specialties,' was designed to define a research agenda for the geriatrics aspects of participating specialties. This paper presents a summary of the research agenda for emergency medicine. METHODS: The RASP was developed by the AGS in conjunction with experts from the participating specialty organizations. A 'content expert' (CE) for each specialty developed a Medline search strategy in conjunction with RAND Health librarians. The CE reviewed the search to identify papers that were germane to research in the emergency care of older patients. The CE and a senior writing group member drafted a paper that synthesized the current literature and suggested areas for further research. A panel consisting of AGS members and emergency physicians with geriatrics expertise reviewed this paper. The research agenda was further refined at a two-day retreat. Two senior geriatricians reviewed the resulting paper. RESULTS: The Medline search for emergency medicine resulted in a list of 3,348 articles; 299 articles were pertinent and reviewed. The search for trauma resulted in a list of 1,838 articles; 133 were reviewed. Research agenda items were defined for multiple topics within geriatric emergency medicine and trauma. CONCLUSION: A research agenda for geriatric emergency medicine has been developed, using a combination of review of current literature and expert opinion.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1111/j.1553-2712.2003.tb01999.x" target="_blank" rel="noreferrer noopener">10.1111/j.1553-2712.2003.tb01999.x</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
2003
Academic Emergency Medicine
Aged
Emergency – Education
Emergency Care – In Old Age
Emergency Medicine
Emergency Service
Geriatric Assessment
Gerson L W
Health Resource Utilization
Health Services Research
Physicians
prehospital care
Research Priorities
Trauma – Therapy – In Old Age
Wilber S T
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
URL Address
<a href="http://doi.org/10.1111/j.1553-2712.2010.00799.x" target="_blank" rel="noreferrer noopener">http://doi.org/10.1111/j.1553-2712.2010.00799.x</a>
Pages
679–686
Issue
7
Volume
17
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Short-term functional decline and service use in older emergency department patients with blunt injuries.
Publisher
An entity responsible for making the resource available
Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
Date
A point or period of time associated with an event in the lifecycle of the resource
2010
2010-07
Subject
The topic of the resource
*Activities of Daily Living; 80 and over; 80 and Over; Academic Medical Centers; Activities of Daily Living; Aged; Bone/physiopathology/therapy; Clinical Assessment Tools; Comorbidity; Confidence Intervals; Descriptive Statistics; Emergency Care – In Old Age; Emergency Patients – In Old Age; Emergency Service; Family; Female; Fisher's Exact Test; Fractures; Functional Status – In Old Age; Geriatric Assessment; Geriatric Functional Assessment; Health Resource Utilization – In Old Age; Hospital/*statistics & numerical data; Hospitals; Human; Humans; Logistic Models; Logistic Regression; Longitudinal Studies; Male; Mental Status Schedule; Nonpenetrating – In Old Age; Nonpenetrating/*physiopathology/*therapy; OARS Multidimensional Functional Assessment Questionnaire; Odds Ratio; Ohio; Outcome Assessment; Outpatients; P-Value; Predictive Value of Tests; Prospective Studies; Questionnaires; Record Review; ROC Curve; Scales; Summated Rating Scaling; Surveys and Questionnaires; T-Tests; Teaching; Treatment Outcome; Treatment Outcomes; Wounds
Creator
An entity primarily responsible for making the resource
Wilber Scott T; Blanda Michelle; Gerson Lowell W; Allen Kyle R
Description
An account of the resource
BACKGROUND: Injuries are a common reason for emergency department (ED) visits by older patients. Although injuries in older patients can be serious, 75% of these patients are discharged home after their ED visit. These patients may be at risk for short-term functional decline related to their injuries or treatment. OBJECTIVES: The objectives were to determine the incidence of functional decline in older ED patients with blunt injuries not requiring hospital admission for treatment, to describe their care needs, and to determine the predictors of short-term functional decline in these patients. METHODS: This institutional review board-approved, prospective, longitudinal study was conducted in two community teaching hospital EDs with a combined census of 97,000 adult visits. Eligible patients were \textgreater or = 65 years old, with blunt injuries \textless48 hours old, who could answer questions or had a proxy. We excluded those too ill to participate; skilled nursing home patients; those admitted for surgery, major trauma, or acute medical conditions; patients with poor baseline function; and previously enrolled patients. Interviewers collected baseline data and the used the Older Americans Resources and Services (OARS) questionnaire to assess function and service use. Potential predictors of functional decline were derived from prior studies of functional decline after an ED visit and clinical experience. Follow-up occurred at 1 and 4 weeks, when the OARS questions were repeated. A three-point drop in activities of the daily living (ADL) score defined functional decline. Data are presented as means and proportions with 95% confidence intervals (CIs). Logistic regression was used to model potential predictors with functional decline at 1 week as the dependent variable. RESULTS: A total of 1,186 patients were evaluated for eligibility, 814 were excluded, 129 refused, and 13 were missed, leaving 230 enrolled patients. The mean (+/-SD) age was 77 (+/-7.5) years, and 70% were female. In the first week, 92 of 230 patients (40%, 95% CI = 34% to 47%) had functional decline, 114 of 230 (49%, 95% CI = 43% to 56%) had new services initiated, and 76 of 230 had an unscheduled medical contact (33%, 95% CI = 27% to 39%). At 4 weeks, 77 of 219 had functional decline (35%, 95% CI = 29% to 42%), 141 of 219 had new services (65%, 95% CI = 58% to 71%), and 123 of 219 had an unscheduled medical contact (56%, 95% CI = 49% to 63%), including 15% with a repeated ED visit and 11% with a hospital admission. Family members provided the majority of new services at both time periods. Significant predictors of functional decline at 1 week were female sex (odds ratio [OR] = 2.2, 95% CI = 1.1 to 4.5), instrumental ADL dependence (IADL; OR = 2.5, 95% CI = 1.3 to 4.8), upper extremity fracture or dislocation (OR = 5.5, 95% CI = 2.5 to 11.8), lower extremity fracture or dislocation (OR = 4.6, 95% CI = 1.4 to 15.4), trunk injury (OR = 2.4, 95% CI = 1.1 to 5.3), and head injury (OR = 0.48, 95% CI = 0.23 to 1.0). CONCLUSIONS: Older patients have a significant risk of short-term functional decline and other adverse outcomes after ED visits for injuries not requiring hospitalization for treatment. The most significant predictors of functional decline are upper and lower extremity fractures.
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1111/j.1553-2712.2010.00799.x" target="_blank" rel="noreferrer noopener">10.1111/j.1553-2712.2010.00799.x</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
*Activities of Daily Living
2010
80 and over
Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
Academic Medical Centers
Activities of Daily Living
Aged
Allen Kyle R
Blanda Michelle
Bone/physiopathology/therapy
Clinical Assessment Tools
Comorbidity
Confidence Intervals
Department of Emergency Medicine
Descriptive Statistics
Emergency Care – In Old Age
Emergency Patients – In Old Age
Emergency Service
Family
Female
Fisher's Exact Test
Fractures
Functional Status – In Old Age
Geriatric Assessment
Geriatric Functional Assessment
Gerson Lowell W
Health Resource Utilization – In Old Age
Hospital/*statistics & numerical data
Hospitals
Human
Humans
Logistic Models
Logistic Regression
Longitudinal Studies
Male
Mental Status Schedule
NEOMED College of Medicine
Nonpenetrating – In Old Age
Nonpenetrating/*physiopathology/*therapy
OARS Multidimensional Functional Assessment Questionnaire
Odds Ratio
Ohio
Outcome Assessment
Outpatients
P-Value
Predictive Value of Tests
Prospective Studies
Questionnaires
Record Review
ROC Curve
Scales
Summated Rating Scaling
Surveys and Questionnaires
T-Tests
Teaching
Treatment Outcome
Treatment Outcomes
Wilber Scott T
Wounds