2023-11-07 15:40:51
According to a study, the risk of a patient over 75 dying in hospital after a night on a stretcher increases from 11.1% to 15.7%.
For a patient over 75 years old, spending a night on a stretcher in the emergency room “increases the risk of hospital mortality by almost 40%”, according to a study published Monday by several teams from AP-HP, Inserm, and the universities of the Sorbonne and Rouen Normandy.
When an elderly patient spends the night on a stretcher, the risk of him dying in hospital increases from 11.1% to 15.7%, according to this study called “No bed Night”, carried out from December 12 to 14, 2022 in 97 emergency reception services in France, including 1,598 patients over 75 years old. 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 requiring daily assistance, this night “increases the risk of mortality by almost twice”, specifies a press release from the AP-HP (Assistance Publique – Hôpitaux de Paris).
“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 a medication that would have a very beneficial effect, refuse him treatment,” commented Professor Yonathan Freund, one of the two emergency doctors who coordinated the study.
The study also shows a higher risk of complications: “more falls, more nosocomial infections or pressure sores for example”. “If all the patients in this study had been able to be hospitalized before nightfall, we would have avoided 3% of deaths,” he noted.
According to Professor Freund, the statistical model used takes into account the comorbidities, age and initial severity of patients and thus makes it possible 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 took place, emergency services were experiencing “a considerable increase in the number of patients requiring emergency hospitalization” due in particular to a “triple concomitant epidemic: Covid-19, influenza , and respiratory syncytial virus (RSV)”, recalls the AP-HP. The situation was “worsened by a reduction in the number of beds available downstream due to a shortage of staff”.
“Measures must be taken”, concludes the AP-HP, and “the objective of ‘zero stretcher beds’ in emergency rooms, in particular for patients over 75 years old, must be considered as a public health objective” .
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