Abstract
Patients with cognitive impairment are frequent users of Emergency Department (ED) and acute hospital units.
The main objective of this study was to analyze main reasons that lead patients with cognitive impairment or dementia to an ED or acute hospital admission. A second objective was to determine whether there were differences in the frequency of visits depending on age and the existence and severity of cognitive impairment.
The cohort of the study included 459 people attended by the Diagnosis and Treatment of Cognitive Disorders Unit (DTDU) of Badalona Serveis Assistencials for the first time (from 2004 to 2008) and followed during 5 years.
There were 154 men and 305 women, with a mean age of 75.9 years. Initial diagnosis were Mild Cognitive Impairment (MCI) (35.1%), Alzheimer’s Disease (22.4%), Vascular Dementia (13.7%), Non cognitive impairment (13.5%), Mixed Dementia (Vascular Dementia and Alzheimer Disease) (10.2%) and Other dementias (5.1%).
380 people were attended at ED (1742 total visits) with a mean of 4.6 visits per patient. Main reasons for visits were falls, injuries and joint pain (29.6%), respiratory disorders (10.5%), digestive disorders (9.4%), urinary infection (3.5%), dizziness (3.3%), behavioural symptoms (2.9%), and other reasons (40.8%). 248 people were admitted at least 1 time in the acute hospital with a mean of 1.2 admissions per patient. Main causes were surgical conditions (28%), respiratory diseases (17.6%), heart diseases (9,1%), injuries (7.1%) and other medical reasons (38.2%).
We found that age was related to higher frequency of ED admission. MCI was found associated with both ED and hospital admission.