Tasa de retorno y características asistenciales de pacientes mayores de 65 años en un servicio de Urgencias en Atención Primaria

Abstract

[EN] Objective: To determine the unexpected return rate to the Primary Care Emergency Service of elderly patients over 65 years old within the following 72 h of a previous visit, as well as to determine the clinical and assistance requirements of these patients. Procedure: Retrospective and observational epidemiologic study. Location: Cotolino's Primary Care Emergency Service in Cantabria, Spain. Participants: 1940 elderly patients over 65 years old were included. These patients returned to the Primary Care Emergency Service in 2016. Main data for the study: The dependent variable was the return rate to the Primary Care Emergency Service. The independent variables were socio-demographic characteristics, health details and medical assistance information. All data was collected from the Primary Care Emergency Service Management Office database. All variables were analysed applying Pearson's chi-squared test and Fisher's exact test, with statistical significance P≤.05. Results: The rate of unexpected return was 2.3%. The average age was 77.4 years old (standard deviation (SD): 8.4), of which the 37.6% were male. The most frequent range of age was from 75 to 84 years old, with males being the predominant group. A history of polymedication was detected in 54.4% of the cases, as well as a medium cardiovascular risk within this group. Nursing professionals attended the 42.2% of these return cases (P<.001). Patients with dysnea (P=.015), scheduled care or scheduled injection returned with a higher frequency (P<.001). It was as well noticed a higher frequency of return for subsequent attention during the months of December and January (P<.001). Conclusions: The rate of unexpected return is low. The main causes why elderly patients returned to the service requiring urgent assistance were issues categorised as unspecific general health indicators and/or respiratory system illnesses. Our proposal is to develop specific protocols combining the work from both Geriatrics and Gerontology professionals, in order to improve the support to this group of population at every Primary Care Emergency Service.