Ambulance Transport of the Oldest Old in Tokyo: A Population-Based Study

BACKGROUND Few studies have investigated ambulance utilization in people aged 85 years or older, ie, the oldest old. METHODS We conducted a 1-year population-based observational study of patients transported by ambulance to emergency departments in Tokyo, Japan, which has a population of about 12 million. Demographic data, symptoms/events associated with ambulance transport, and the proportion of hospital admissions were recorded. Transport rates by age and sex were calculated using data for the background population and ambulance transports, and the 10 most frequent symptoms/events requiring transport were compared between the oldest old and those aged 65 to 84 years. RESULTS Of the 642,764 patients who were transported to hospitals by ambulances, 59 570 (9%) were aged ≥ 85 years; 64% were women. The annual ambulance transport rate for this population was 250 per 1000/year and was significantly greater than the rate (90 per 1000/year) for those aged 65 to 84 years. The highest rate was for men aged 85 to 99 years (292 per 1000/year). Among the oldest old, the most frequent reason for ambulance transport was fall (38.5 per 1000/year), and the symptom most likely to result in hospital admission was dyspnea. CONCLUSIONS The ambulance transport rate for the oldest old was high, particularly among men aged ≥ 95 years. To reduce the need for ambulance transport among the oldest old, preventive care is needed to reduce falls and acute exacerbations of cardiac and respiratory disorders.