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Gerontologic evaluation in emergency room : A best way for old patients
David BOUAZIZ, S BAILLEUX, PM TARDIEUX, P PRAS
Introduction :
In our hospital , a lot of old patients older than 70 years arrive in emergency room . Unfortunately a lot of them , are directed in first intention in nongeriatric units.
Materiels and methods :
When this problem appear , the Gerontologic Mobile Team , in collaboration with Emergency Unit , proposed a new tool for gerontologic evaluation.This tool, called EGU Score, is based on Sega score and HARP grid . EGU allows an early identification of fragile old patients, who need to go in geriatric units.This score is easy and fast . The nurses and the doctors can use it for each patient.With this tool, wich takes into account the situation of the patient 5 days before the acute episode , we know :
- Age
- Leaving in ( Residence , residence with assistances , old people?s home )
- The number of drugs used
- The cognitive functions
- Mood
- Falls
- Nutritionnal statute
- Other diseases
- Motricity
- Continence
- Activities of daily living
Each of them , will be scored ( 0 , 1 or 2 ) .Other complementary data also form part of this evaluation.
Results :
The study made on the first 200 patients shows 3 types of patients :
1 ? Score lower or equal to 8 : Monopathologic patients , who should go in speciality units as well as a younger patient who have the same symptomatology . No fragility .
2 ? Score between 9 and 11 : Patients with latent fragility , for wich a geriatric evaluation is essential
3 ? Score equal to or higher than 12 : Patients with real fragility who must go in geriatric units as soon as possible
Conclusion :
In addition to the profile risks which the EGU score brings , the use of a common language should help to find the best way in hospital for old patients .
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