Dementia and Geriatric Cognitive Disorders

Beauchet O.a,b,c,d· Afilalo M.e· Allali G.f· Lubov J.c· Galery K.b· Launay C.P.c

Author affiliations

aDepartments of Medicine, University of Montreal, Montreal, QC, Canada
bResearch Centre of the Geriatric University Institute of Montreal, Montreal, QC, Canada
cDepartment of Medicine, Division of Geriatric Medicine, Sir Mortimer B. Davis Jewish General Hospital and Lady Davis Institute for Medical Research, McGill University, Montreal, QC, Canada
dLee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
eEmergency Department, Jewish General Hospital, McGill University, Montreal, QC, Canada
fLeenaards Memory Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland

Dement Geriatr Cogn Disord

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Article / Publication Details

First-Page Preview

Received: February 09, 2022
Accepted: April 02, 2022
Published online: May 12, 2022

Number of Print Pages: 6
Number of Figures: 1
Number of Tables: 2

ISSN: 1420-8008 (Print)
eISSN: 1421-9824 (Online)

For additional information: https://www.karger.com/DEM

Abstract

Introduction: Older people with major neurocognitive disorders (MNCDs) visiting the emergency department (ED) are at high risk of hospital admissions. The “Emergency Room Evaluation and Recommendations” (ER2) tool decreases the length of stay (LOS) in the hospital when older people visiting ED are hospitalized after an index ED visit, regardless of their cognitive status. Its effect on hospital admissions has not yet been examined in older people with MNCD visiting ED. This study aimed to examine whether ER2 recommendations were associated with incident hospital admissions and LOS in ED in older people with MNCD visiting ED. Methods: A total of 356 older people with MNCD visiting ED of the Jewish General Hospital (Montreal, Quebec, Canada) were recruited in this non-randomized, pre-post-intervention, single arm, prospective and longitudinal open label trial. ED staff and patients were blinded of the ER2 score, and patients received usual ED care during the observation period, whereas ED staff were informed about the ER2 score, and patients had ER2 tailor-made recommendations in addition to usual care during the intervention period. Hospital admissions and the LOS in ED were the outcomes. Results: There were less incident hospital admissions (odds ratio ≤ 0.61 with p ≤ 0.022) and longer LOS in ED (coefficient beta ≥4.28 with p ≤ 0.008) during the intervention period compared to the observation period. Discussion/Conclusion: ER2 recommendations have mixed effects in people with MNCD visiting ED. They were associated with reduced incident hospital admissions and increased LOS in ED, suggesting that they may have benefits in addition to usual ED care.

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First-Page Preview

Received: February 09, 2022
Accepted: April 02, 2022
Published online: May 12, 2022

Number of Print Pages: 6
Number of Figures: 1
Number of Tables: 2

ISSN: 1420-8008 (Print)
eISSN: 1421-9824 (Online)

For additional information: https://www.karger.com/DEM

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