Why do geriatric patients attend otolaryngology emergency rooms?

With an aging population, health care of the elderly population is becoming increasingly important; however, the principles of geriatric medicine and issues of concern specific to geriatric otolaryngologic patients have not been widely applied.

To qualitatively analyze otolaryngological (EN1) emergencies in a geriatric population in an ENT emergency department (ED).

In this retrospective study the medical records of patients > or = 65 years of age who attended our ENT-ED between 3 pm and 8 am and who were observed and/or treated by the on-call otorhinolaryngologist at Sheba Medical Center in 2009 were reviewed for age, gender, main complaint, and preliminary diagnosis. Allergic reactions, balance disorders, epistaxis, head/facial trauma and swallowing-related complaints were considered true emergencies.

The staff in the ENT-ED examined and treated 1-10 geriatric patients daily (mean 2.35). A total of 597 subjects met the study entry criteria (median age 75 years); 16.6% were > or = 85 years old. There was approximately equal gender representation. More elderly patients presented to the ENT-ED on the weekends (37.9% of the total) compared to weekdays (62.1%). There were 393 patients (65.8%) with true emergencies, of which epistaxis, balance disorders and head and facial trauma were the most common diagnoses (20.1%, 15.75% and 13.7%, respectively), while 46.5% of all vestibulopathy cases involved benign paroxysmal positional vertigo.

More than 65% of visits of the elderly presenting to ENT-ED involve true emergencies. This growing population may benefit from the presence of geriatric specialists in emergency departments.