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Characteristics of patients hospitalised in an emergency department observation unit in Japan

Toshiya Mitsunaga, Yuhei Ohtaki, Nobuaki Kiriyama, Kei Ohtani, Wataru Yajima, Takahiko Hibi, Satoshi Takeda
  • Toshiya Mitsunaga
    Department of Emergency Medicine, Jikei University School of Medicine, Minato-ku, Tokyo, Japan | toshiya.m@jikei.ac.jp
  • Yuhei Ohtaki
    Department of Emergency Medicine, Jikei University School of Medicine, Minato-ku, Tokyo, Japan
  • Nobuaki Kiriyama
    Department of Emergency Medicine, Jikei University School of Medicine, Minato-ku, Tokyo, Japan
  • Kei Ohtani
    Department of Emergency Medicine, Jikei University School of Medicine, Minato-ku, Tokyo, Japan
  • Wataru Yajima
    Department of Emergency Medicine, Jikei University School of Medicine, Minato-ku, Tokyo, Japan
  • Takahiko Hibi
    Department of Emergency Medicine, Jikei University School of Medicine, Minato-ku, Tokyo, Japan
  • Satoshi Takeda
    Department of Emergency Medicine, Jikei University School of Medicine, Minato-ku, Tokyo, Japan

Abstract

In Japan, transporting elderly patients to emergency departments has recently posed serious problems, including a longer average time from patients’ initial emergency calls to their arrival at hospitals. To manage emergency departments more efficiently, many hospitals in the United States and some other developed countries, including Japan, introduced emergency department observation units (EDOU). However, because the usefulness of EDOUs in managing elderly patients remains uncertain, we analysed data of patients admitted to a Japanese university hospital’s EDOU to gauge its efficacy. We followed 1,426 patients admitted to the hospital’s EDOU from 1 January 2011 to 31 December 2014. The average age of patients who stayed in the EDOU increased, whereas the average length of time that they spent there decreased. Although the percentage of patients older than 65 years increased slightly, from 36.42% (2011–2012) to 37.73% (2013–2014), the proportion of those patients between the two periods did not significantly change (P = .61). Moreover, their average length of stay was 2.16 ± 0.91 days, whereas patients younger than 65 years stayed for significantly less time (1.92 ± 0.82 days). By condition, approximately 36% of patients older than 65 years presented with non-neurosurgical trauma, approximately 59% presented with other forms of trauma, but proportions of both categories of trauma were significantly smaller in patients younger than 65 years (nonneurosurgical trauma, 23%; all trauma, 47%). Most elderly patients with limb trauma prepped for surgery were transferred to other hospitals after a few days. Results suggest that the EDOU at the university hospital has served to as a buffer for regional emergency medical systems in Japan, especially given the continued ageing of the Japanese population.

Keywords

Observation unit; Emergency medicine; Japan, University hospital; Elderly patients.

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Submitted: 2018-02-26 06:37:20
Published: 2018-08-02 16:26:35
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Copyright (c) 2018 Toshiya Mitsunaga, Yuhei Ohtaki, Nobuaki Kiriyama, Kei Ohtani, Wataru Yajima, Takahiko Hibi, Satoshi Takeda

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