COMPARING OLDER ADULTS PRESENTING WITH DEHYDRATION AS A PRIMARY DIAGNOSIS VERSUS A SECONDARY DIAGNOSIS IN THE EMERGENCY DEPARTMENT
J.C. Mentes, H. Aronow
J Aging Res Clin Practice 2016;5(4):181-186
Objectives: We compared clinical data of older adults, >65 years of age who presented to a large urban ED with a primary diagnosis of dehydration, ICD code 276.5 (PD) to those with dehydration as a secondary diagnosis (SD). Design: Comparative study using a large hospital emergency room administrative database (2008-2009). Setting: Large urban hospital. Participants: 231 participants mean age 81 years, 86 with PD were matched on age, gender and ethnicity to 145 with SD. Measurements: We collected data on chief complaints, laboratory tests, medical diagnoses, and medications as listed in the database. Results: Among major diagnoses, those with SD were more likely to have an infection. A logistic regression with SD as dependent variable and using variables significant at the univariate level revealed that infections (AOR= 6.7, 95% CI 2.92, 15.08) and difficulties with activities of daily living (AOR= 2.19, 95% CI 1.02-4.66) were more likely in those presenting with SD than with PD. Patients with SD were less likely to have a diabetes diagnosis (AOR=.32, 95% CI .14, .72), have diarrhea (AOR= .50, 95% CI .22, 1.19), and present with a dry mouth (AOR= .39, 95% CI, .19, .78). Those with SD were significant more likely to be repeat ED users, have longer hospital stays and have higher hospital costs than those with PD. Conclusions: Comorbid dehydration is often obscured by the seriousness of the presenting condition in the ED. This creates a missed opportunity to educate the patients and their families about the importance of maintaining adequate hydration, which may prevent rehospitalization.
J.C. Mentes ; H. Aronow (2016): Comparing older adults presenting with dehydration as a primary diagnosis versus a secondary diagnosis in the emergency department. The Journal of Aging Research and Clinical Practice (JARCP). http://dx.doi.org/10.14283/jarcp.2016.118