Utility of clinical characteristics in identifying depression in geriatric ED patients

Abstract

We will determine if clinical characteristics can be useful in identifying depression in geriatric Emergency Department (ED) patients. We have provided a cross-sectional observational study of geriatric patients presenting to an urban university-affiliated public hospital. A brief self-rated depression scale (SRDS) was used to identify depression. Clinical characteristics, examined retrospectively, included chief complaint, chronic illnesses, mode and time of arrival and discharge disposition. Relative prevalence of depression was calculated for these clinical characteristics. 70 (27%; 95% Cl, 22% to 32%) of 259 patients were found to be depressed by the SRDS. Patients with nonspecific chief complaints were more commonly depressed than patients with system-specific chief complaints, but not significantly (relative prevalence 1.6; 95% Cl, 1.0 to 2.4; p = 0.19). The relative prevalence of depression also did not vary significantly when analyzed by specific chronic illness ( P = 0.42) except cardiac disease (1.6;95% Cl, 1.1 to 2.4), PM or night arrival (1.3; 95% Cl, 0.8 to 2.0; p = 0.17), ambulance use (1.1; 95% Cl, 0.7 to 1.7; p = 0.88), or need for medical admission (1.0; 95% Cl, 0.7 to 1.5;p = 0.97). Depression is common in geriatric ED patients. Clinical characteristics fail to identify elderly ED patients who are likely to be depressed. Use of a brief SRDS can aid in recognition of depression in this group.