[Elders of 75 and over at an emergency service].

CONTEXT Elderly patients represent an important and growing part of the emergency department activity. PURPOSE To describe population aged of 75 and over admitted in an emergency department without programming and then compare patients addressed with a letter of referral or not. METHODS A prospective transversal study was carried out over one month in the emergency department of the hospital of Mâcon. It concerned all patients aged of 75 and over admitted at the emergency department. RESULTS The study concerned 459 passages of elders (17% of admissions during the period), among whom 40% were addressed with a letter of referral. Mean age was 83.4, with a sex-ratio of 0.6. The hospitalization rate is significantly higher among the letter addressed group: 84% vs 72% (p<0.01). The Emergency room reception of elderly people was evaluated as required for 70% of cases (essentially for medical reasons) and the family physician could have planed the hospitalization for 21% of cases. The mean duration stay was 8.6 days. The mortality at one month was 6%, without significant difference between the two groups. Readmission rate after 3 months was of 20% one more time at least during the period. DISCUSSION Elderly people passage through the emergency department tends to become the admission way to the hospital. An important part of these patients are addressed with a letter of referral, which does not modify the patient's orientation. Nevertheless, some could avoid emergency room passage. This report has to bring us to a reflexion about a work with the physicians to welcome in best these elders at hospital.