Factors predicting transferal after psychiatric emergency management in the elderly

Abstract

The purpose of this study was to examine the demographic and clinical characteristics that differentiate between elderly and non-elderly visitors in the psychiatric emergency room (ER), and to identify factors predicting transferal after psychiatric emergency management in the elderly. Data were collected over four years for patients who visited the psychiatric ER. The elderly were defined as patients older than 65 years old. Demographic and clinical characteristics were analyzed using the chi(2)-test for categorical data and t-tests for continuous data. Multivariate logistic regressions were carried out to find predictive factors associated with being transferred to a general hospital for elderly visitors in the psychiatric ER. Elderly patients made up 3.4% of all included visitors (n = 243) during the four-year period. The mean number of visits for elderly visitors was 1.63 +/- 1.18, ranging from 1 to 7. The chi(2)-test and the t-test indicated that the elderly visitors were different from controls in many demographic and clinical variables. Multivariate logistic regression analysis showed that being transferred to a general hospital for elderly visitors in the psychiatric ER was associated with age (odds ratio = 1.32) and a greater number of previous psychiatric hospitalizations (odds ratio = 1.42). Patients without a thought-form problem also required transferal to a general hospital more often in our study. The study suggested that elderly visitors in the psychiatric ER were a unique group, and specific considerations should be included in the intervention for these patients.