Characterization of Older Emergency Department Patients Admitted to Psychiatric Units.

Title

Characterization of Older Emergency Department Patients Admitted to Psychiatric Units.

Creator

Stiffler Kirk A; Kohli Erol; Chen Oriana; Frey Jennifer A

Publisher

Journal of clinical medicine research

Date

2015
2015-11

Description

BACKGROUND: Many older patients presenting to emergency departments (EDs) with psychiatric complaints require admission to geropsychiatric units (GPUs). The medical evaluation needed prior to this is not understood. Our goal was to understand ED evaluation practices for patients admitted to the GPU through the ED and understand the medical problems identified after admission. METHODS: Via retrospective chart review, we abstracted demographics, medical history, ED complaint, evaluation, length of stay, and diagnosis. The number of patients later transferred from the GPU and the reasons for such transfers were also recorded. RESULTS: Of 100 patients reviewed, the average age was 78 years. Admission diagnoses were agitation/mania (30%), depression/suicidal ideation (28%), change in mental status/confusion (12%) and other (30%). Most had at least one prior psychiatric and medical diagnosis (77%, 60%). Common ED tests ordered were basic metabolic panel (BMP) (96%), complete blood count (CBC) (94%), urinalysis (UA) (89%), electrocardiogram (EKG) (69%), alcohol level (62%), urine toxicology (61%), chest X-ray (51%), and CT scan of the head (71%). Abnormal findings included urinalysis (24.7%), CBC (23.4%), toxicology (23%), BMP (21.9%), head CT (21.1%), chest X-ray (13.7%), ECG changes (10.1%), and alcohol (4.8%). Five of the 100 GPU admissions were later transferred to a medical floor. CONCLUSION: Most GPU admissions have previous psychiatric and medical issues and are admitted for agitation/mania or depression/suicidal ideation. A certain percentage of patients are transferred out due to medical issues despite ED evaluation. However, it is unlikely that further ED testing would reduce this percentage. Further research of medical screening for geropsychiatric patients may elucidate ideal medical clearance procedures.

Subject

Emergency medicine; Geriatric; Psychiatry; Screening

Identifier

Rights

Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).

Pages

840–844

Issue

11

Volume

7

Citation

Stiffler Kirk A; Kohli Erol; Chen Oriana; Frey Jennifer A, “Characterization of Older Emergency Department Patients Admitted to Psychiatric Units.,” NEOMED Bibliography Database, accessed June 17, 2021, https://neomed.omeka.net/items/show/4977.

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