Introduction: The prevalence of neurocognitive disorders (NCDs) increases with age and is associated with cognitive impairment. Older patients with NCD admitted to the emergency department (ED) are readmitted after discharge to home more often than those without NCD. Comprehensive geriatric assessment (CGA) is effective for improving clinical outcomes in older patients; however, the usefulness of CGA for older patients with NCD admitted to the ED has not been investigated. The main objective of our study is to assess the effectiveness of a geriatric emergency medicine unit (GEMU) for elderly patients with NCD admitted to the ED. Methods: This historical cohort study included patients aged 75 years and older with NCD admitted to the ED of Limoges University Hospital in France over a 4-year period. We compared patients treated in our hospital’s GEMU, the MUPA unit (exposed group), and patients who received standard care by emergency physicians (control group). The primary end point was the incidence of 30-day readmissions. Results: The study included 801 patients admitted to the ED between January 1, 2015, and December 31, 2018 (400 in the exposed group). Of those, 72.5% were female, and the mean age was 87 ± 5 years. After adjusting for confounding factors, the 30-day readmission rate was significantly associated with the MUPA unit intervention. Conclusion: CGA in a GEMU improved health outcomes in elderly patients with NCD in the ED. We recommend that all EDs include a geriatric team, such as the MUPA unit, to treat all patients with NCD admitted to the ED.
Dement Geriatr Cogn Disord

中文翻译：

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老年急诊医学科治疗老年患者神经认知障碍的有效性：MUPACog研究结果

简介：神经认知障碍（NCD）的患病率随年龄增长而增加，并与认知障碍有关。与没有NCD的患者相比，进入急诊室（ED）的老年NCD患者在出院后重新入院的频率更高。全面的老年医学评估（CGA）可有效改善老年患者的临床结局；但是，尚未研究CGA对老年急诊室NCD患者的有效性。我们研究的主要目的是评估老年急诊医学科（GEMU）对老年急诊科NCD患者的有效性。方法：这项历史性队列研究包括了在法国利摩日大学医院急诊室接受了为期4年的75岁及以上的NCD患者。我们比较了在我们医院的GEMU，MUPA单元（暴露组）中接受治疗的患者以及在急诊医师的指导下接受标准护理的患者（对照组）。主要终点是30天再次入院的发生率。结果：该研究纳入了2015年1月1日至2018年12月31日之间ED的801例患者（暴露组为400例）。其中，女性占72.5％，平均年龄为87±5岁。调整混杂因素后，30天再入院率与MUPA单位干预显着相关。结论：GEMU中的CGA改善了ED中NCD老年患者的健康结局。我们建议所有急诊科都包括一个老年小组，例如MUPA单位，以治疗所有接受急诊科的NCD患者。
Dement Geriatr Cogn Disord