Emergency department outcome of elderly patients assisted by professional home services, the EPIGER study.
Details
Request a copy Under indefinite embargo.UNIL restricted access
State: Public
Version: Final published version
License: Not specified
Serval ID
serval:BIB_868159CDC682
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Emergency department outcome of elderly patients assisted by professional home services, the EPIGER study.
Journal
BMC geriatrics
Working group(s)
EPIGER IRU-SFMU study group
Contributor(s)
Serre P., Arnaud A., Dugat E., Occelli C., Lanoux T., Jacquet E., Moretto C., Devillard A., Bordais A., Maurin O., Kraif M., Caffier A., Duchenne J., Gillet S., Milojevitch E., Tissier C., Kilic S., Uchlinger V., Gonzalez N., Lacoste V., Pouzoulet S., Khoury A., Marguet P., Zamour C., Proust A., Dessena A., Saura F., Schindler A., Gelin E., Tendron L., Cailleux I., Basso M.H., Houze-Cerfon V., Oudet J., Ah-Koon B., Babet T., Bereau J., Vally R., Souchaud E., Scouarnec C., De Stabenrath O., Vuillot O., Giraud I., Bebien L., Chauvel N., Le Normand T., Rouchy C., Arnault I., Brenkmann V., Viglino D., Maiello E., Matas O., Lemarchand R., Duffait Y., Bonhomme C., Martinez M., Viallon A., Legoff Q., Blonstein B., Fort P.A., Vicenzi O., Ruche V., Millet A., Chouihed T., Baugnon D., Daniel N., Boulanger B., Galant J., Le Hot H., Rothmann C., Guenot I., Cochonneau M., Smaiti N., Lachery P., Wiel E., Thiriez S., Abdelli L., Carpentier A., Kasdali R., Ramaherison T., Guidez T., Bailly C., Poher F., Idrissi A., Humbert K., Andregnette P., Pic D., Dublanchet N., Giroud G., N'Guyen G., Jainsky L., Lacrouts M., Liepa M.P., Esturoune G., Ximenes A., Randrianasolo I., Mathe M., Chable H., Le Cardinal G., Zix-Minni A.M., Le Borgne P., Schweitzer F., Ben Hammouda K., Schmitt J., Compte G., Delaroche M., Di Filippo C., Potinet V., Regal O., Nahani A., Faivre J., Sturiale T., Touil M., Di Rollo M., Laine O., Gerain M., Latappy M., Ageron F.X., Vallenet C., Leleu A., Blandin M., Paquet A.L., Fievet-Brochot M.L., Hansconrad E., Vivien B., Principe A., Thiebaud P.C., Trabattoni E., Burggraff E., Boust E., Massol V., Benet X., Foubert Q., Jardel B., Roussel M., Joly L.M., Ovtcharenko M., Bedrici K., Abdeljaouad M., Mauger-Briche C., Berton L., Dalle L., Violeau M., Amizet L., Fontaine F., Colonna A., Tida J., Cwicklinski E., Fradin P., Vallejo C., Frigui L., Bregigeon S., Porche M., Le Jan A., Desclefs J.P., Andrianjafy H., Wajzer L., Hung T.T., Beaune S., Lenglet H., Le Bail G., Bouchara A., Kouka M.C., Wargon M., David S., Khalid M., Phlippoteau C., Diez S., Sende J., Baermann X., Legall C., Fehre A., Etiennar C., Roudiak N., Talfournier J., Lefebvre C., Claessens Y.E., Carron P.N., Dami F., Popotte E., Belkouch A., Pujo J.M.
ISSN
1471-2318 (Electronic)
ISSN-L
1471-2318
Publication state
Published
Issued date
21/09/2020
Peer-reviewed
Oui
Volume
20
Number
1
Pages
355
Language
english
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: epublish
Publication Status: epublish
Abstract
For the elderly population living at home, the implementation of professional services tends to mitigate the effect of loss of autonomy and increases their quality of life. While helping in avoiding social isolation, home services could also be associated to different healthcare pathways. For elderly patients, Emergency Departments (EDs) are the main entrance to hospital where previous loss of autonomy is associated to worst hospital outcomes. Part of elderly patients visiting EDs are still admitted to hospital for having difficulties coping at home without presenting any acute medical issue. There is a lack of data concerning elderly patients visiting EDs assisted by home services. Our aim was to compare among elderly patients visiting ED those assisted by professional home services to those who do not in terms of emergency resources' use and patients' outcome.
A multicenter, prospective cohort study was performed in 124 French EDs during a 24-h period on March 2016.Consecutive patients living at home aged ≥80 years were included. The primary objective was to assess the risk of mortality for patients assisted by professional home services vs. those who were not. Secondary objectives included admission rate and specific admission rate for "having difficulties coping at home". The primary endpoint was in-hospital mortality. Cox proportional-hazards regression model was used to test the association between professional home services and the primary endpoint. Multi variables logistic regressions were performed to assess secondary endpoints.
One thousand one hundred sixty-eight patients were included, median age 86(83-89) years old,32% were assisted by professional home services. The overall in-hospital mortality rate was 7%. Assisted patients had more investigations performed. Home services were not associated with increased in-hospital mortality (HR = 1.34;95%CI [0.68-2.67]), nor with the admission rate (OR = 0.92;95%CI [0.65-1.30]). Assisted patients had a lower risk of being admitted for "having difficulties coping at home" (OR = 0.59;95%CI [0.38-0.92]).
Professional home services which assist one-third of elderly patients visiting EDs, were not associated to lower in-hospital mortality or to an increased admission rate. Assisted patients were associated to a lower risk of being admitted for «having difficulties coping at home».Professional home services could result in avoiding some admissions and their corollary complications.
Clinicaltrial.gov - NCT02900391 , 09/14/2016, retrospectively registered.
A multicenter, prospective cohort study was performed in 124 French EDs during a 24-h period on March 2016.Consecutive patients living at home aged ≥80 years were included. The primary objective was to assess the risk of mortality for patients assisted by professional home services vs. those who were not. Secondary objectives included admission rate and specific admission rate for "having difficulties coping at home". The primary endpoint was in-hospital mortality. Cox proportional-hazards regression model was used to test the association between professional home services and the primary endpoint. Multi variables logistic regressions were performed to assess secondary endpoints.
One thousand one hundred sixty-eight patients were included, median age 86(83-89) years old,32% were assisted by professional home services. The overall in-hospital mortality rate was 7%. Assisted patients had more investigations performed. Home services were not associated with increased in-hospital mortality (HR = 1.34;95%CI [0.68-2.67]), nor with the admission rate (OR = 0.92;95%CI [0.65-1.30]). Assisted patients had a lower risk of being admitted for "having difficulties coping at home" (OR = 0.59;95%CI [0.38-0.92]).
Professional home services which assist one-third of elderly patients visiting EDs, were not associated to lower in-hospital mortality or to an increased admission rate. Assisted patients were associated to a lower risk of being admitted for «having difficulties coping at home».Professional home services could result in avoiding some admissions and their corollary complications.
Clinicaltrial.gov - NCT02900391 , 09/14/2016, retrospectively registered.
Keywords
Aged, Aged, 80 and over, Emergency Service, Hospital, Hospital Mortality, Hospitalization, Humans, Prospective Studies, Quality of Life, Elderly, Emergency care, Healthcare access, Home services, Loss of autonomy
Pubmed
Web of science
Open Access
Yes
Create date
25/02/2021 15:35
Last modification date
09/08/2024 14:52
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