Factors associated with mortality of older adults hospitalized via emergency departments in Korea

Purpose: As the rate of older people visiting Emergency Departments (EDs) increases, nurses are responsible for identifying patients at risk of poor outcomes and providing preventive interventions. The aim of this study was to identify the factors associated with the mortality of older adults hospitalized through EDs. Methods: The study design was a retrospective correlational design using the electronic medical records from a tertiary hospital in Korea. Data were collected from January 3 to March 6, 2016 through the hospital information center based on elderly patients admitted from January 1, 2011 to August 31, 2015. The study variables included general and admission characterstics, disease characteristics, and mortality of older patients visiting EDs. Results: Of the 9,896 patients, the mortality rate was 7.4%; highest in patients aged over 86 years, men, or those hospitalized from nursing homes. Older adults arriving by private ambulance were 2.36 times more likely to die than walk-ins, and 1.38 times more likely for those using the 119 government emergency ambulance. Older patients hospitalized for more than four weeks were 2.17 times more likely to die than those hospitalized for less than a week. Conclusion: Based on the study findings ward nurses will be able to early detect older patients at risk of poor outcomes and make better clinical decisions to improve the quality of nursing care. Nurses can propose health policies such as stricter management of the private ambulance service and considering the most efficient length of hospital stay for older adults hospitalized through EDs.