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KMID : 0605720100160020130
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Journal of the Korean Society of Biological Therapies in Psychiatry
2010 Volume.16 No. 2 p.130 ~ p.140
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Characteristics of Elderly Psychiatric Patients Visited to Emergency Department
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Ko Young-Ju
Cheon Jin-Sook
Byun Hyun-Woo
Lee Ji-Sang
Kim Kang-Ryul
Oh Byoung-Hoon
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Abstract
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Objectives: The numbers of geriatric patients visiting emergency department have been increasing with the increase of geriatric population, especially among those with psychiatric problems. The aims of this study are to know the frequency and trend of visiting emergency department among elderly psychiatric patients, to analyse their demographic and clinical characteristics, and to identify related factors.
Methods: Among elderly psychiatric patients with age over 60(N=276) who had visited Emergency Medical Center, Kosin University Gospel Hospital from 2000 thru 2009, medical records or electronic medical records of 187 cases were analysed by three psychiatrist who were blind to those patients.
Results: 1) The numbers of elderly psychiatric patients were gradually increasing for 10 years versus total numbers of patients(0.18% in 2000, 0.25% in 2009) and versus total numbers of geriatric patients(0.81% in 2000, 0.87% in 2009). However, The increase of elderly psychiatric patients versus total numbers of psychiatric patients became so rapid as 2.5-3 times in 2006(7.58% in 2000, 27.54% in 2009). 2) Most frequent demographic and clinical characteristics of the elderly psychiatric patients visiting emergency department for 10 years were sixties(66.9%), urban dwellers(92.5%), visting during weekdays(67.9%) and stay for 6-24 hours(43.3%)(p<0.05, respectively). The managements were resulted in discharge against medical advice(30.5%), admission to other department(26.7%), discharge after management(19.8%), admission to psychiatric ward(16.6%), transfer to other hospital(3.7%) and being expired(2.7%). 3) The most frequent reasons for visiting emergency department of elderly psychiatric patients were suicidal attempt(13.4%), pain(10.7%), consciousness change(10.7%), continuos alcohol drinking(10.2%) in order. The most frequent psychiatric diagnoses were alcohol dependence(20.9%), depression(19.3%), adjustment disorder(11.2%), delirium(10.7%), anxiety disorder(9.6%) and dementia(8.6%). The most frequent comorbities were cardiovascular diseases(27.3%), hepatic and gastrointestinal diseases(13.9%), neurological diseases(12.3%), endocrinological diseases(10.7%), respiratory diseases(8.6%), renal and urinary diseases(7.5%) and cancer(7.0%) in order. 4) There was significant correlation between psychiatric diagnosis and gender of elderly psychiatric patients visiting emergency department. The causes were significantly correlated with route, arrival time and stay hours. The route of visiting emergency department was significantly correlated with arrival time and stay hours. There was significant correlation between stay hours and management in the emergency department.
Conclusion: Elderly psychiatric patients required much time and resources in the emergency department. To solve the rapidly growing problems related to the emergency care for the elderly psychiatric patients, analysing data of visiting emergency department at first and then active preparation of medical personnel shoud be preceded.
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KEYWORD
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Emergency department, Elderly psychiatric patients, Suicidal attempt, Alcohol dependence, Cardiovascular diseases
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