For a patient over 75 years of age, spending a night on a stretcher in the emergency room “increases the risk of in-hospital mortality by almost 40%,” according to a study published on Monday by several teams from AP-HP, Inserm and universities. of the Sorbonne and Rouen Normandy.
When an elderly patient spends the night on a stretcher, the risk of dying in the hospital increases from 11.1% to 15.7%, according to this study called “Night without a bed”, carried out from December 12 to 14, 2022 in 97 emergency shelters. services in France, including 1,598 patients over 75 years of age. The study was published in the journal Jama Internal Medicine.
The risk of complications also increases.
Among patients with a limited level of autonomy and who need daily assistance, tonight “the risk of mortality almost doubles,” says a statement from the AP-HP (Public Assistance – Paris Hospitals).
“These are things that were suggested, anticipated, but today we have shown that there is a real association. Not hospitalizing a patient is like not giving them a medication that would have a very beneficial effect, denying them treatment,” commented Professor Yonathan Freund. one of the two emergency physicians who coordinated the study.
The study also shows a higher risk of complications: “more falls, more nosocomial infections or pressure ulcers, for example.” “If all the patients in this study could have been hospitalized before nightfall, we would have avoided 3% of the deaths,” he noted.
According to Professor Freund, the statistical model used takes into account the comorbidities, age and initial severity of the patients and thus allows “to compare two exactly equivalent patients.”
Reduction in the number of beds.
The factors that can explain this excess mortality are, for example, not sleeping, not having sufficient follow-up because the service is overloaded or not always having treatment on time,” he explained.
In December 2022, when the study was carried out, emergency services were experiencing “a considerable increase in the number of patients requiring urgent hospitalization” due, in particular, to a “triple concomitant epidemic: Covid-19, influenza and respiratory syncytial virus (VRS)”, recalls the AP-HP. The situation was “worsened by the reduction in the number of beds available downstream due to staff shortages.”
“Measures must be taken,” concludes the AP-HP, and “the goal of ‘zero stretchers’ in emergency rooms, particularly for patients over 75 years of age, should be considered a public health goal.”
Source: BFM TV
