Evidence map›Paper›PMID 32645113›Full record

ArticlePloS one2020

Concerns of older patients and their caregivers in the emergency department.

Noortje Zelis, Sarah E Huisman, Arisja N Mauritz, Jacqueline Buijs, Peter W de Leeuw, Patricia M Stassen

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02946398 (Risk Stratification in Elderly Patients in the Emergency Department), which is not on this map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02946398 completednot on this map

Risk Stratification in Elderly Patients in the Emergency Department

TypeobservationalSponsorZuyderland Medisch CentrumRan2016 to 2019Enrolled600ConditionsElderly Patiënts
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Observational
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Noortje ZelisDepartment of Internal Medicine and Gastroenterology, Zuyderland Medical Center, Heerlen, The Netherlands.ORCID 0000-0003-0015-5240
Sarah E HuismanDivision of General Internal Medicine, Department of Internal Medicine, Section Acute Medicine, Maastricht University Medical Center, Maastricht University, Maastricht, The Netherlands.
Arisja N MauritzDivision of General Internal Medicine, Department of Internal Medicine, Section Acute Medicine, Maastricht University Medical Center, Maastricht University, Maastricht, The Netherlands.
Jacqueline BuijsDepartment of Internal Medicine and Gastroenterology, Zuyderland Medical Center, Heerlen, The Netherlands.
Peter W de LeeuwDepartment of Internal Medicine and Gastroenterology, Zuyderland Medical Center, Heerlen, The Netherlands.
Patricia M StassenDivision of General Internal Medicine, Department of Internal Medicine, Section Acute Medicine, Maastricht University Medical Center, Maastricht University, Maastricht, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOlder emergency department (ED) patients often have complex problems and severe illnesses with a high risk of adverse outcomes. It is likely that these older patients are troubled with concerns, which might reflect their preferences and needs concerning medical care. However, data regarding this topic are lacking.

methodsThis study is a sub study of a prospective, multicenter, observational cohort study among older medical ED patients (≥65 years). Patients or their caregivers were asked about their illness-related concerns during the first stage of the ED visit using a questionnaire. All concerns were categorized into 10 categories, and differences between patients and caregivers, and between age groups were analyzed. Odds Ratios were calculated to determine the association of the concerns for different adverse outcomes.

resultsMost of the 594 included patients (or their caregivers) were concerned (88%) about some aspects of their illness or their need for medical care. The most often reported concerns were about the severity of disease (43.6%), functional decline (9.4%) and dying (5.6%). Caregivers were more frequently concerned than patients (p<0.001) especially regarding the severity of disease (50.5 vs 39.6%, p = 0.016) and cognitive decline (10.8 vs. 0.3%, p <0.001). We found no difference between age groups. The concern about dying was associated with 30-day mortality (OR 2.89; 95%CI: 1.24-6.70) and the composite endpoint (intensive- or medium care admission, length of hospital stay >7 days, loss of independent living and unplanned readmission within 30 days) (OR 2.32; 95%CI: 1.12-4.82). In addition, unspecified concerns were associated with mortality (OR 1.88; 95%CI: 1.09-3.22).

conclusionThe majority of older patients and especially their caregivers are concerned about their medical condition or need for medical care when they visit the ED. These concerns are associated with adverse outcomes and most likely reflect their needs regarding medical care. More attention should be paid to these concerns because they may offer opportunities to reduce anxiety and provide care that is adjusted to their needs.

trial registrationThis study was registered on clinicalTriagls.gov (NCT02946398).

Indexed as

CaregiversPatientsAgedAged, 80 and overCognitive AgingCohort StudiesDelivery of Health CareEmergency Service, HospitalFemaleHumansIndependent LivingLength of StayMaleMiddle AgedOdds RatioPatient Discharge

Identifiers

PMID32645113
PMCPMC7347152

What Socratic holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.