Characteristics and Mortality of Older Adults Presenting to the Emergency Department With Generalized Weakness

Abstract Background Worldwide aging of the population leads to an increased number of older, more complicated patients attending emergency departments (ED). Presenting symptoms of various conditions can be vague in this population, leading to delayed and potentially missed diagnoses. In the current study, we sought to characterize the demographics, final diagnoses, and outcomes of older patients who are referred to the ED for generalized weakness. METHODS We conducted a retrospective observational study in an urban tertiary hospital ED. Participants were patients aged 65 years or older who were referred to a geriatric evaluation in the ED. A total of 2,226 patients met study eligibility criteria and were enrolled between April 1, 2010 and March 31, 2013. Data on physical characteristics, discharge diagnoses, and vital status were obtained from an electronic medical database and the Ministry of the Interior. RESULTS There was no significant difference between the “weakness” and “non-weakness” groups for patients who were discharged from the ED. For admitted patients, statistically significant differences (although of no clinical significance) were noted for white blood cells (WBC) and sodium levels. Both statistically and clinically significant differences were observed for functional level. The main discharge diagnosis for admitted patients was an infection (24%), followed by "nonspecific diagnoses" (22%). Social issues as the main diagnosis were attributed to < 1% of the patients. Patients who were hospitalized for weakness were less likely to survive during the following year compared with patients hospitalized for non-weakness, but that was not the case for patients who were not admitted. CONCLUSIONS Patients admitted due to weakness were significantly more dependent on others for carrying out their daily activities. They were also more likely to die during and following hospitalization. Most of them were diagnosed during the hospitalization as having a specific medical condition.