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Einstein (São Paulo)

Print version ISSN 1679-4508On-line version ISSN 2317-6385

Abstract

SANTOS, Fabiana Silvestre dos; DIAS, Bianca Menezes  and  REIS, Adriano Max Moreira. Emergency department visits of older adults within 30 days of discharge: analysis from the pharmacotherapy perspective. Einstein (São Paulo) [online]. 2020, vol.18, eAO4871.  Epub Oct 24, 2019. ISSN 1679-4508.  https://doi.org/10.31744/einstein_journal/2020ao4871.

Objective

To analyze, from the pharmacotherapy perspective, the factors associated to visits of older adults to the emergency department within 30 days after discharge.

Methods

A cross-sectional study carried out in a general public hospital with older adults. Emergency department visit was defined as the stay of the older adult in this service for up to 24 hours. The complexity of drug therapy was determined using the Medication Regimen Complexity Index. Potentially inappropriate drugs for use in older adults were classified according to the American Geriatric Society/Beers criteria of 2015. The outcome investigated was the frequency of visits to the emergency department within 30 days of discharge. Multivariate logistic regression was performed to identify the factors associated with the emergency department visit.

Results

A total of 255 elderly in the study, and 67 (26.3%) visited emergency department within 30 days of discharge. Polypharmacy and potentially inappropriate medications for older adults did not present a statistically significant association. The diagnosis of heart failure and Medication Regimen Complexity Index >16.5 were positively associated with emergency department visits (OR=2.3; 95%CI: 1.04-4.94; p=0.048; and OR=2.1; 95%CI: 1.11-4.02; p=0.011), respectively. Furthermore, the diagnosis of diabetes mellitus and chronic kidney disease were protection factors for the outcome (OR=0.4; 95%CI: 0.20-0.73; p=0.004; and OR=0.3; 95%CI: 0.13-0.86; p=0.023).

Conclusion

The diagnosis of heart failure and Medication Regimen Complexity Index >16.5 were positively associated with the occurrence of an emergency department visit within 30 days of discharge.

Keywords : Emergency service, hospital; Aged; Drug therapy.

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