The impact of geriatricians in the emergency department: A prospective observational study

The primary aim of this study was to evaluate the impacts of an emergency department (ED)-embedded geriatric service in redirecting older adults from an acute inpatient hospital admission through a targeted assessment by a geriatrician in ED (GED). Secondary aims were to describe the utilisation of local community health and outpatient services to successfully redirect older patients from an acute hospital admission and determine the re-attendance rates of patients to ED within 28 days after initial presentation.

This was a prospective observational study performed in two stages due to COVID-19-related interruption. All referrals by ED physicians related to older adults with geriatric syndromes were reviewed by GED. Of these patients, those with a planned disposition for an inpatient admission were included in the primary and secondary analysis of this study.

A total of 273 patients were seen by GED. More than half of older adults (n = 147) planned for inpatient admission were directly discharged from ED. The failure rate, defined by older adults re-presenting to ED within 28 days with the same initial complaint and needing hospital admission, totalled 4%. Comorbid frailty, cognitive impairment and polypharmacy were common.

Evaluation of older adults presenting to ED by a geriatrician facilitates safe hospital admission prevention.