J. Basic. Appl. Sci. Res., 3(8)562-568, 2013 © 2013, TextRoad Publication ISSN 2090-4304 Journal of Basic and Applied Scientific Research www.textroad.com * Corresponding Author: Dr.Alireza Maleki Rastekenari, resident of emergency medicine. Immam Hossein hospital, Shahid beheshti university of medical science, Tehran, Iran. Email: dr.maleki.rk@gmail.com, tel: +982173432380 Short-term Outcome of Elderly Patients Discharged from an Emergency Department Mohammad Mehdi Forouzanfar 1 , Hamid Reza Hatamabadi 2,3 , Alireza Maleki Rastekenari 2 , Behrooz Hashemi 1 , Alireza Baratloo 1 , Farnoush Yousefi Milani 2 , Nastaran sadat Mahdavi 2 1 Emergency Medicine Department Shohada-E-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2 Emergency Medicine Department, Immam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran 3 Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of medical sciences, Tehran, Iran ABSTRACT Background: Elderly people are at risk of higher morbidity and mortality rates whether in normal or medical conditions. In this research, the short-term outcomes of elderly and non-elderly groups discharged from the emergency department, Imam Hossein Hospital were studied. Methodology: This cross-sectional study was conducted in 2012 on two groups of elderly patients (> 65 years) and non-elderly patients (< 65 years), all of who had been admitted to the emergency department. One week and three weeks after discharge, re-referral of the patients was followed up by phone conversation. The data was analyzed using SPSS Ver. 20 and the level of statistical significance was considered to be p <0.05. Results: Totally 286 patients participated in this study, including 143 elderly and 143 non-elderly patients, 48.3% of whom were females and 51.7% were males. Neurological problems were the most common disorder among the elderly (14.6%), and hypertension was the most common previous disease history in them (8.7%). In sum, 27.9% of the elderly were readmitted one week after discharge, and the rate was 8.3% for the next follow- up, i.e. three weeks after discharge, which was higher than the rate of re-referral for non-elderly patients (p < 0.05). The leading cause for re-referral of elderly people in the first follow-up was neurological diseases (11%) and heart diseases in the second follow-up (26.4%). Conclusion: The re-referral rate after discharge among the elderly is high, so it is necessary that complete diagnostic and therapeutic measures and rehabilitation cares be performed to improve the conditions of the elderly and to reduce treatment costs and the length of stay (LOS). KEYWORDS: The elderly, Re-referral, Emergency, Follow-up, Short-term outcome. INTRODUCTION Today, medical, social and economic development has increased life expectancy and has reduced mortality rate, and consequently the number of the senior in the world is increasing day by day. Elderliness means being over 60 years old. The elderly population is projected to be about 14% of the world population within the next thirty years. Population aging has also begun in Iran. Based on a population index, if more than 12% of the total population will be 60 years old and older, or if 10% of the total population will be 65 years old and older, the population will be called an aged one (1, 2). Nowadays, many researches are conducted on outcomes of the elderly after discharge (6, 7). Most of such researches are performed regarding the mortality rate, readmission and the functionality of the elderly after discharge (8, 9). The elderly patients discharged from the emergency departments of the hospitals are often at the risk of readmission, hospitalization and loss of independence and even death (15-19). In addition, almost a quarter of elderly patients who are discharged from the hospital will be re-referred within three months after discharge (20). Studies show that the elderly are admitted to the emergency departments of the hospitals more than the youth due to three reasons (15, 16). They often suffer from chronic diseases at this age and need more care; their clinical and social problems are not resolved properly, and even when they are provided with suitable facilities, it may be difficult for them to access them. Recent studies regarding the short-term follow-up of the elderly have shown that patients who are discharged from the emergency departments are at risk of functional decline, readmission to hospital, hospitalization and death (21-26). Up to 24% of the elderly will be re-referred to hospitals within three months after discharge; 24% of the elderly will be readmitted at the emergency departments and 10% will die (27-29). Old age, functional and independence decline, living alone, lack of social support, various diseases, taking multiple medications, hospitalization or emergency department admission are the most important undesirable consequences for this group (30, 31). Due to the vulnerability of the elderly population, they require additional attention in terms of medical care; in other word, providing better medical care can reduce re-admission and associated additional costs of treatment for them drastically. The aim is to enable elderly people to live independently and perform their own 562