2293 Targeted geriatric assessment in the emergency department: does it make a difference?

Abstract Introduction Older people represent between 21 to 40% of Emergency Department (ED) users and proportionally use more ED services than any other age group. Method Retrospective review was undertaken from 13th January 2022 until 23rd December 2022 in older patients discharged from the ED ambulatory area following a targeted geriatric assessment and recommended follow-up interventions at the geriatric clinic. Two groups were identified, those compliant to follow-up interventions (GpC) and those that defaulted (GpD). Demographic information, hospital utilisation and mortality (up to one year), and any post-visit fragility fractures were reviewed. Data collection included identification of osteoporosis or osteopenia and cognitive decline during or following the visit and findings were compared across the 2 groups. Results 137 patients were reviewed, and 79 patients (58%) compliant to geriatric follow-up (GpC) and 58 patients (42%) non-compliant (GpD). Age and sex were similar, 80 vs 80 years, range 65–98 years and female s 58% vs 62%. ED 7-day re-attendances were similar, 9% vs 12%, but 30-day hospital admissions were lower 10% vs 16%, although 1 year ED attendances were higher in the compliant group, 56% vs 45%, which did not translate to more 1 year hospital admissions 35% vs 33%. Mortality was 11% vs 14%. More patients were identified as having osteoporosis 30% vs 21% or high-risk osteopenia 18% vs 9%, and a larger number of patients had unevaluated bone health in the non-compliant group 19% vs 47%. However, fragility fractures were similar, 9% vs 7%. AMT was 7.94 vs 5.02, range 0–10 and cognitive impairment identified in 43% vs 33%, with dementia in 24% vs 14%, Mild Cognitive Impairment in 15% vs 7% and suspected but not evaluated in 4% vs 12%. Conclusion Targeted geriatric assessment has shown earlier and improved identification of underlying frailty and geriatric syndromes.