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Table 3 ED visits of NHRs

From: Age and sex differences in emergency department visits of nursing home residents: a systematic review

Author (year)

Prevalence, incidence or number of ED visits and follow-up

Age-specific and sex-specific analyses

Admission to hospital

Number of ED visits per resident

Prevalence or incidence

Regression/model

Ackermann et al. (1998) [22]

110 visits per 100 resident years (1488 ED visits made by 873 residents) Follow-up: 1 year

 

Holm’s Sequential Rejection Algorithm

Men had a 17% higher overall ED use rate than women (p = 0.025).

No association between the overall ED use rate of a NH and the age distribution of its patients.a

Admitted to hospital: 42.4%

Not admitted: 56.3%

Died: 1.3%

Admitted to hospital:

Age

≤ 64 years: 36.6%

65–74 years: 44.9%

75–84 years: 41.8%

85+ years: 44.6%

Sex

Female: 41.6%

Male: 43.9%

Number of ED visits per resident

1: 60.5%

2: 22.3%

3: 9.5%

4: 4.2%

5+: 3.4%

Hsiao and Hing (2014) [15]

123.2 visits per 100 resident years (4970 ED visits) Follow-up: 1 month

Number of visits per 100 resident years

Age

65–74 years: 153.2 (95% CI 138.1–168.3)

75–84 years: 124.3 (95% CI 115.5–133.1)

85+ years: 113.0 (95% CI 105.0–121.0)

Sex

Female: 111.6 (95% CI 104.5–118.7)

Male: 154.5 (95% CI 142.3–166.7)

 

Admitted to hospital: 48.7%

Not admitted: 33.5%

Multivariable analysis

Admitted to hospital:

Age

65–74 years: Reference

75–84 years: OR = 0.95 (95% CI 0.75–1.20)

85+ years: OR = 1.02 (95% CI 0.82–1.27)

Sex

Male: OR = 1.10 (95% CI 0.93–1.30)

Proportion of residents seen in ED less than 72 h ago: 2.4%

(95% CI 1.9–3.0)

Kihlgren et al. (2014) [14]

150 visits per 100 resident years

NHRs with at least one ED visit: 29%

(314 ED visits made by 209 residents)

Follow-up: 1 year

Age

75–84 years: 25%

85+ years: 30%

(p = 0.213)

Sex

Female: 28%

Male: 33%

(p = 0.196)

  

Number of ED visits per resident

1: 71%

(number of referrals ranged between 1 and 7)

Average number of referrals:

Female: 1.4

Male: 1.7

LaMantia et al. (2016) [23]

2001: 146.0 visits per 100 resident years

2008: 215.5 visits per 100 resident yearsb

NHRs with at least one ED visit: 47%

Follow-up: 1 year

 

Multivariable cox proportional hazard regression

Age

HR = 0.98 (95% CI 0.98–0.99; p < 0.0001)

Sex

Male: HR = 0.95 (95% CI 0.87–1.05; p = 0.3610)c

Admitted to hospital: 36.4%

Not admitted: 63.1%

Died: 0.52%

 

McGregor et al. (2014) [18]

62.6 visits per 100 resident yearsc,d (10,710 ED visits) Follow-up: 3 years

 

Poisson regression

Adjusted (for sex and age)

Age

IRR = 1.00 (95% CI 1.00–1.00)

Sex

Male: IRR = 1.38 (95% CI 1.28–1.49)

  

Stephens et al. (2012) [24]

NHRs with at least one ED visit: 62%

(82,335 ED visits)

Follow-up: 1 year

Age

65–75 years: 62.7%

76–85 years: 63.9%

86+ years: 59.7%

Sex

Female: 60.5%

Male: 65.3%

Multivariable logistic regression

Age

65–75 years: Reference

76–85 years: OR = 1.11 (95% CI 1.07–1.15; p ≤ 0.0001)

86+ years: OR = 1.03 (95% CI 0.99–1.07)

Sex

Male: OR = 1.05 (95% CI 1.02–1.09; p ≤ 0.001)

  

Stephens et al. (2014) [25]

ED visits: 112,119

Follow-up: 1 year

 

Poisson regression

Adjusted

Age

65–75 years: Reference

76–85 years: IRR = 0.95 (95% CI 0.93–0.97; p < 0.0001)

86+ years: IRR = 0.90 (95% CI 0.88–0.92 p < 0.0001)

Sex

Male: IRR = 1.14 (95% CI 1.12–1.17; p < 0.0001)

Admitted to hospital: 44.16%

Multivariable logistic regression

Admitted to hospital:

Age

65–74 years: Reference

76–85 years: OR = 1.07 (95% CI 1.02–1.13)

86+ years: OR = 1.11 (95% CI 1.05–1.17)

Sex

Male: 1.10 (95% CI 1.06–1.15)

 
  1. IRR, Incidence Rate Ratio; OR, Odds Ratio; HR, Hazard Ratio
  2. aNo other information available
  3. bAuthors reported per 1000 NH bed days
  4. cCalculated from data given in the publication
  5. dFor-profit facilities: 69/100 resident years, 1.9/1000 resident days; non-profit facilities: 70/100 resident years, 1.93/1000 resident days; public owned facilities: 51/100 resident years, 1.39/1000 resident days