Clinical characteristics of elderly patients with critical diseases in emergency department:analysis of 2798 cases

Objective To analyze the clinical characteristics of the critical diseases in the elderly in emergency department . Methods A tolal of 2 798 elderly cases with critical diseases in emergency department(from 2000 to 2006)were divided into three groups according to their ages. The composition of fatality rate and organ function failure of the critical diseases were compared between the groups. Results ①The elderly cases with critical disease as percentage of total critical cases in emergency department tended to decline(χ2=539.43, P0.01). ② The number of cases in 70-79 age group ranked first, accounting for 39.4%, that in 60-69 age group ranked second,accounting for 38.6%, and that in 80 and over age group ranked third, accounting for 22.1%.The number of cases with nervous system diseases was 1 054, ranked first in diseases of various systems, accounting for 37.7%. Of the 1 054 cases, 858 belonged to the brain vascular disease(467 cerebral hemorrhage and 391 brain infarction), accounting for 81.4%.The numbers of the circulatory diseases and trauma ranked second and third respectively. ③The proportions of the nervous diseases, trauma and circulatory diseases ranked first three in 60-69 age group . The proportions of nervous diseases, circulatory diseases and respiratory diseases ranked the first three in 70-79 and 80 and over age groups .④The fatality rate of the critical diseases in the elderly in emergency department was 3.3%. The fatality rates of circulatory diseases (8.1%), acute poisoning (5.0%) and trauma (4.4%) ranked the first three. ⑤Of the 2 798 cases, 359 belonged to organ failure, accounting for 12.8%. In the 359 cases, the number of cases in 70-79 age group ranked first, accounting for 47.1%.⑥Of the 359 cases, 316 belonged to one-organ failure, accounting for 88.0%. The numbers of cases with respiratory failure and heart failure ranked first and second. ⑦The fatality rate of 33 cases with two-organ failure was 9.1% and that of 10 cases with three and more-organ failure was 80.0%. Conclusions For the elderly with critical diseases, the emergency department should focus on the nervous diseases(especially brain vascular diseases)and the circulatory diseases, and emergency treatment should focus on respiratory failure and heart failure.