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Emergency Medical Services | Public Health & Policy

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Emergency department utilization in elderly patients: a report from the National Emergency Department Information System (NEDIS) of Korea, 2018-2022
Clin Exp Emerg Med. 2023;10(S):S26-S35.   Published online November 8, 2023
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Emergency department utilization in elderly patients: a report from the National Emergency Department Information System (NEDIS) of Korea, 2018-2022
Clin Exp Emerg Med. 2023;10(S):S26-S35.   Published online November 8, 2023
Close
Objective
With general aging of the population, emergency department (ED) utilization by elderly patients is increasing. In this study, we analyzed data on ED visits of patients aged 65 years and older in Korea.
Methods
The study is a retrospective analysis of National Emergency Department Information System (NEDIS) data from 2018–2022, focusing on patients aged 65 years and older who visited EDs across Korea. ED utilization data were analyzed using Korean Triage and Acuity Scale (KTAS) scores. The patients were divided into three age groups, and common chief complaints and diagnoses were identified. Age- and sex-standardized ED visits per 100,000 population and outcomes were also analyzed.
Results
During the study period, there was a total of 9,803,065 elderly patient ED visits. The mean patient age was 76.4±7.6 years, and 47.6% were men. The ED mortality rate and in-hospital mortality rate were 1.8% and 4.6%, respectively. The KTAS scores 1–2 group accounted for 11.0% of patients, KTAS score 3 group for 42.5%, KTAS scores 4–5 group for 37.2%, and KTAS score unknown group for 9.4%. When patients were categorized into three age groups, the oldest group exhibited the highest rates of KTAS score 1, severe illness diagnoses, and mortality. The most frequently reported chief complaint was abdominal pain, and the most common diagnosis was light headedness. When analyzing the data by year, the COVID-19 outbreak had a discernible impact on ED visits and clinical outcomes.
Conclusion
Over the past 5 years, ED visits for elderly patients have averaged 26,050 per 100,000 population per year, with a temporary decline during the COVID-19 pandemic and a subsequent upward trend.

Citations

Citations to this article as recorded by  Crossref logo
  • The Prognostic Value of the Clinical Frailty Scale in Critically Ill Older Adult Patients in the Emergency Department
    Young Woo Um, You Hwan Jo, Jae Hyuk Lee, Inwon Park, Ji Eun Hwang, Seung Hyun Kang, Narae Kim
    The Journal of Emergency Medicine.2026; 80: 33.     CrossRef
  • Interventions according to patient severity in an emergency department based short stay unit: Nursing intervention classification and social network analysis
    Dain Lee, Soyoung Kim, Jaehoon Kim, Joohee Chung, Sunhee Yun, Yeonhee Lee, Il Hyun Lee, Hanjong Park
    International Emergency Nursing.2026; 84: 101730.     CrossRef
  • Emergency Nurses’ Experiences of Triaging Geriatric Trauma Patients: A Qualitative Study
    Yunli Yang, Yanan Liu, Yihua Ding, Yuxuan Qin, Wei Yu, Xiang Li, Huarong Wang, Yanhong Zhang, Shuyan Wang
    Journal of Emergency Nursing.2026; 52(4): 949.     CrossRef
  • Determinants of Emergency Department Length of Stay and the Mediation Effect of Disposition Among Injury Patients in South Korea: A Nationwide Retrospective Study
    Min-Seok Choi, Su-il Kim, Yun-Deok Jang
    Healthcare.2026; 14(4): 469.     CrossRef
  • Comparison of prognosis in emergency department elderly septic shock patients with initial hypotension versus delayed hypotension
    Chaeeun Lee, Gil Joon Suh, Sung-Hyuk Choi, Sung Phil Chung, Won Young Kim, Tae Ho Lim, Sangchun Choi, Tae Gun Shin, Sangun Nah, Sangsoo Han
    European Journal of Emergency Medicine.2026; 33(3): 169.     CrossRef
  • Association between emergency department crowding and mortality: a nationwide analysis stratified by emergency department levels: a retrospective cohort study
    Minha Kim, Jin-Hee Lee, Minyoung Choi, Doyeop Kim, Hanseok Chang, Sejin Heo, Seung Jin Maeng, Tae Gun Shin, Eunsil Ko, Hansol Chang
    BMC Emergency Medicine.2026;[Epub]     CrossRef
  • Emergency department utilisation in an ageing population: a retrospective observational study
    Hanzhang Xu, Fahad Javaid Siddiqui, Zhi Xiong Koh, Andrew Fu Wah Ho, Marcus Eng Hock Ong
    Singapore Medical Journal.2026; 67(4): 241.     CrossRef
  • Early prognostication of septic shock in Korean adults aged 80 years and over: serum albumin combined with Sequential Organ Failure Assessment score
    Sang-Min Kim, Seung Mok Ryoo, Woon Yong Kwon, Kyuseok Kim, Tae Ho Lim, Sung Pil Chung, Sung-Hyuk Choi, Won Young Kim
    Acute and Critical Care.2026; 41(2): 304.     CrossRef
  • A team without a name: emergency medicine recognition and its impact on working conditions and well-being
    Megan Gates Kemnitz, Eugenia-Maria Lupan-Muresan, Francis Somville, Bruno Barcella, Noaa Shopen, María de los Angeles López Hernández, Eric P. Heymann
    Medizinische Klinik - Intensivmedizin und Notfallmedizin.2025; 120(6): 481.     CrossRef
  • ANALYSIS OF GERIATRIC POPULATION VISITING EMERGENCY DEPARTMENT: A PROSPECTIVE STUDY
    JAHNU BHOJ NAGAL, BHUVNESHWARI JAITAWAT, TEJPAL YADAV, KAVITA JAIN
    International Journal of Current Pharmaceutical Research.2025; : 129.     CrossRef
  • Occupational Toxic Effect Episodes in a University Hospital, 2021–2024: A Descriptive Analysis Within the Korean Occupational Disease Surveillance Center
    Yangwoo Kim, Ha-Eun Lee, Jei Kim, Tae-Won Jang
    Safety and Health at Work.2025; 16(4): 438.     CrossRef
  • Impact of direct prehospital transport on mortality in patients with severe trauma based on the injury severity score: a nationwide observational study in the Republic of Korea
    Sun Ju Kim, KeunKyun Kim, Oh Hyun Kim, Chan Yong Park
    Osong Public Health and Research Perspectives.2025; 16(4): 381.     CrossRef
  • Factors Influencing Hospitalization Among Older Adults in Tokyo's Emergency Medical Services: The Role of Cerebral Disease and Seasonal Variations
    Kohri Megumi, Ryotaro Suga, Kensuke Suzuki, Satoo Ogawa, Hiroyuki Yokota
    Geriatrics & Gerontology International.2025; 25(12): 1724.     CrossRef
  • Structured simulation-based education in emergency medicine residency programs: Pavia’s proposal for competence development and crisis management (Italy)
    Bruno Barcella, Marco Bonzano, Stefano Perlini, Francesco Salinaro, Emergency Medicine Simulation Group
    Emergency Care Journal.2025;[Epub]     CrossRef
  • The prevalence and factors of adverse health outcomes in Chinese older emergency patients: a cohort study
    Xinyu Ren, Manping Gu, Kebiao Zhang, Hong Li, Rui He
    BMC Geriatrics.2025;[Epub]     CrossRef
  • Emergency department crowding: a national data report
    Hansol Chang, Eunsil Ko, Jin-Hee Lee, Minha Kim, Taerim Kim, Tae Gun Shin, Seongjung Kim
    Clinical and Experimental Emergency Medicine.2024; 11(4): 331.     CrossRef
  • Factors that predict emergency department length of stay in analysis of national data
    Minha Kim, Sujeong Lee, Minyoung Choi, Doyeop Kim, Junsang Yoo, Tae Gun Shin, Jin-Hee Lee, Seongjung Kim, Hansol Chang, Eunsil Ko
    Clinical and Experimental Emergency Medicine.2024; 12(1): 35.     CrossRef
  • 9,729 View
  • 259 Download
  • 17 Web of Science
  • 17 Crossref
Original Articles

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Emergency department utilization and risk factors for mortality in older patients: an analysis of Korean National Emergency Department Information System data
Clin Exp Emerg Med. 2021;8(2):128-136.   Published online June 30, 2021
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Emergency department utilization and risk factors for mortality in older patients: an analysis of Korean National Emergency Department Information System data
Clin Exp Emerg Med. 2021;8(2):128-136.   Published online June 30, 2021
Close
Objective
With trends in population aging an increasing number of older patients are visiting the emergency department (ED). This study aimed to identify the characteristics of ED utilization and risk factors for in-hospital mortality in older patients who visited EDs.
Methods
This nationwide observational study used National Emergency Department Information System data collected during a 2-year period from January 2016 to December 2017. The characteristics of older patients aged 70 years or older were compared with those of younger patients aged 20 to 69 years. Risk factors associated with in-hospital mortality were analyzed by multivariable logistic regression.
Results
A total of 6,596,423 younger patients and 1,737,799 older patients were included. In the medical and nonmedical older patient groups, significantly higher proportions of patients were transferred from another hospital, utilized emergency medical services, had Korean Triage and Acuity Scale scores of 1 and 2, required hospitalization, and required intensive care unit admission in the older patient group than in the younger patient group. ED and post-hospitalization mortality rates increased with age; in particular, older medical patients aged 90 or older had an in-hospital mortality rate of 9%. Older age, male sex, transfer from another hospital, emergency medical service utilization, a high Korean Triage and Acuity Scale score, systolic blood pressure <100 mmHg, respiratory rate >20/min, heart rate >100/min, body temperature <36°C, and altered mental status were associated with in-hospital mortality.
Conclusion
Development of appropriate decision-making algorithms and treatment protocols for high risk older patients visiting the ED might facilitate appropriate allocation of medical resources to optimize outcomes.

Citations

Citations to this article as recorded by  Crossref logo
  • Development and Internal Validation of an Early Warning Predictive Model for Critically Ill Patients in the Emergency Department Utilizing Easily Obtainable Clinical Indicators
    Xurui Li, Jian Lv, Hui Guo, Hongling Li, Qian Zhao, Huijun Qi, Jianguo Li
    Risk Management and Healthcare Policy.2026; Volume 19: 1.     CrossRef
  • Emergency department presentations for suicide and self-harm in Korea, 2020–2024: an epidemiological study using the National Emergency Department Information System (NEDIS) database
    Yuri Choi, Jinwoo Jeong, Borami Lim, Myeong Il Cha
    Clinical and Experimental Emergency Medicine.2026; 13(1): 98.     CrossRef
  • Impact of the 2024 Korean medical workforce crisis on transfers in a pediatric emergency center: including comparative analyses with adults
    Sung-Ha Kim, Jin Hee Kim, Jae-Hyun Kwon, Soo Hyun Park, Min-Jung Kim, Young-Hoon Byun, Ho-Young Song, So-Hyun Paek, Inge Roggen
    PLOS One.2026; 21(5): e0348189.     CrossRef
  • Hypothermia and Mortality Among Children in the Emergency Department
    Lucy Campbell, Aarthi Kottapalli, Leslie Hueschen, Jonathan R. Higgins, Erin J. Meyer, Laura F. Sartori, Paria M. Wilson, Naghma S. Khan, Alexander Rogers, Sriram Ramgopal
    Pediatrics.2026;[Epub]     CrossRef
  • Factors associated with hospitalization among older patients with mild traumatic injuries presenting to the emergency department in Korea: a retrospective observational study
    Songhee Jeong, Younghui Hwang
    Journal of Korean Biological Nursing Science.2026; 28(2): 353.     CrossRef
  • Commentary on “Predictive value of the Hemoglobin, Albumin, Lymphocyte and Platelet score for mortality in geriatric patients presenting to the emergency department”
    Zeinab Mohseni Afshar, Mohammad Barary, Farhad Bagherian, Arefeh Babazadeh, Soheil Ebrahimpour
    Geriatrics & Gerontology International.2025; 25(6): 830.     CrossRef
  • Comparison of early warning scores for predicting outcomes in adult and older patients in emergency department: Multicenter study
    Sung Jin Bae, Ho Sub Chung, Yunhyung Choi, Yoon Hee Choi, Ji Yeon Lim, Keon Kim, Dong Hoon Lee
    The American Journal of Emergency Medicine.2025; 96: 91.     CrossRef
  • Cyber-Secure IoT and Machine Learning Framework for Optimal Emergency Ambulance Allocation
    Jonghyuk Kim, Sewoong Hwang
    Applied Sciences.2025; 15(13): 7156.     CrossRef
  • Transfer versus direct-visit patients in medically underserved emergency departments: a retrospective cohort study
    Kyongmin Sun, Youjin Lee, Jungsil Lee
    BMC Emergency Medicine.2025;[Epub]     CrossRef
  • Factors related to the frequent use of emergency department services in Korea
    Eun Deok Cho, Bomgyeol Kim, Do Hee Kim, Sang Gyu Lee, Suk-Yong Jang, Tae Hyun Kim
    BMC Emergency Medicine.2023;[Epub]     CrossRef
  • Emergency department utilization in elderly patients: a report from the National Emergency Department Information System (NEDIS) of Korea, 2018-2022
    Sun Young Lim, You Hwan Jo, Seongjung Kim, Eunsil Ko, Young Sun Ro, Jungeon Kim, Sumin Baek
    Clinical and Experimental Emergency Medicine.2023; 10(S): S26.     CrossRef
  • Epidemiology of suicide attempts and self-harm in emergency departments: a report from the National Emergency Department Information System (NEDIS) of Korea, 2018–2022
    Kwang Yul Jung, Taehui Kim, Young Sun Ro
    Clinical and Experimental Emergency Medicine.2023; 10(S): S69.     CrossRef
  • Epidemiologic trends of patients who visited nationwide emergency departments: a report from the National Emergency Department Information System (NEDIS) of Korea, 2018–2022
    Hyun Ho Yoo, Young Sun Ro, Eunsil Ko, Jin-Hee Lee, So-hyun Han, Taerim Kim, Tae Gun Shin, Seongjung Kim, Hansol Chang
    Clinical and Experimental Emergency Medicine.2023; 10(S): S1.     CrossRef
  • Mortality and incidence rate of acute severe trauma patients in the emergency department: a report from the National Emergency Department Information System (NEDIS) of Korea, 2018–2022
    Jung-Youn Kim, Young-Hoon Yoon, Sung Joon Park, Won Pyo Hong, Young Sun Ro
    Clinical and Experimental Emergency Medicine.2023; 10(S): S55.     CrossRef
  • Epidemiology of stroke in emergency departments: a report from the National Emergency Department Information System (NEDIS) of Korea, 2018–2022
    Sung Eun Lee, Hyo Jin Kim, Young Sun Ro
    Clinical and Experimental Emergency Medicine.2023; 10(S): S48.     CrossRef
  • Acute myocardial infarction diagnosed in emergency departments: a report from the National Emergency Department Information System (NEDIS) of Korea, 2018–2022
    Shin Ahn, Eunsil Ko, Young Sun Ro
    Clinical and Experimental Emergency Medicine.2023; 10(S): S42.     CrossRef
  • Factors Associated with Emergency Department Visits and Consequent Hospitalization and Death in Korea Using a Population-Based National Health Database
    Junhee Park, Yohwan Yeo, Yonghoon Ji, Bongseong Kim, Kyungdo Han, Wonchul Cha, Meonghi Son, Hongjin Jeon, Jaehyun Park, Dongwook Shin
    Healthcare.2022; 10(7): 1324.     CrossRef
  • 10,453 View
  • 129 Download
  • 18 Web of Science
  • 17 Crossref

Injury & Prevention

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Factors associated with injury severity among users of powered mobility devices
Clin Exp Emerg Med. 2021;8(2):103-110.   Published online June 30, 2021
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Factors associated with injury severity among users of powered mobility devices
Clin Exp Emerg Med. 2021;8(2):103-110.   Published online June 30, 2021
Close
Objective
To examine the features of powered mobility device-related injuries and identify the predictors of injury severity in such settings.
Methods
Emergency Department-based Injury In-depth Surveillance data from 2011 to 2018 were used in this retrospective study. Participants were assigned to the mild/moderate and severe groups based on their excess mortality ratio–adjusted injury severity score and their general injury-related factors and injury outcome-related factors were compared.
Results
Of 407 patients, 298 (79.2%) were assigned to the mild/moderate group and 109 (26.8%) to the severe group. The severe group included a higher percentage of patients aged 70 years or older (43.0% vs. 59.6%, P=0.003), injuries incurred in the daytime (72.6% vs. 82.4%, P=0.044), injuries from traffic accidents and falls (P=0.042), head injuries (38.6% vs. 80.7%, P<0.001), torso injuries (16.8% vs. 32.1%, P=0.001), overall hospital admission (28.5% vs. 82.6%, P<0.001), intensive care unit admission (1.7% vs. 37.6%, P<0.001), death after admission (1.4% vs. 10.3%, P=0.034), and total mortality (0.7% vs. 9.2%, P<0.001). The odds ratios (ORs) for injury severity were as follows: age 70 years or older (OR, 2.124; 95% confidence interval [CI], 1.239–3.642), head injury (OR, 10.441; 95% CI, 5.465–19.950), and torso injury (OR, 4.858; 95% CI, 2.495–9.458).
Conclusion
The proportions of patients aged 70 years or older, head and torso injuries, injuries from traffic accidents and falls, and injuries in the daytime were higher in the severe group. Our results highlight the need for measures to address these factors to lower the incidence of severe injuries.

Citations

Citations to this article as recorded by  Crossref logo
  • Area-Level Socioeconomic Inequalities in Intracranial Injury-Related Hospitalization in Korea: A Retrospective Analysis of Data From Korea National Hospital Discharge Survey 2008–2015
    Hang A Park, Federico E. Vaca, Kyunghee Jung-Choi, Hyesook Park, Ju Ok Park
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • Factors associated with the injury severity of falls from a similar height and features of the injury site: a retrospective study
    Dae Hyun Kim, Jae-Hyug Woo, Yang Bin Jeon, Jin-Seong Cho, Jae Ho Jang, Jea Yeon Choi, Woo Sung Choi
    Journal of Trauma and Injury.2023; 36(3): 187.     CrossRef
  • Study on Elevator Recognition Techniques for Upper-Limb-Disabled Wheelchair Users
    Daewe Kim, Su-Hong Eom, Eung-Hyuk Lee
    Applied Sciences.2023; 13(22): 12182.     CrossRef
  • 8,253 View
  • 91 Download
  • 4 Web of Science
  • 3 Crossref

Critical Care

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Use of the National Early Warning Score for predicting in-hospital mortality in older adults admitted to the emergency department
Clin Exp Emerg Med. 2020;7(1):61-66.   Published online March 31, 2020
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Use of the National Early Warning Score for predicting in-hospital mortality in older adults admitted to the emergency department
Clin Exp Emerg Med. 2020;7(1):61-66.   Published online March 31, 2020
Close
Objective
The National Early Warning Score (NEWS), based on the patients’ vital signs, detects clinical deterioration in critically ill patients and is used to reduce the incidence of in-hospital cardiac arrest. However, although mortality prediction based on vital signs may be difficult in older patients, the effectiveness of the NEWS has not yet been evaluated in this population. This study aimed to test the hypothesis that an elevated NEWS at admission increases the mortality risk in older patients admitted to the emergency department (ED).

Methods
We conducted a single-center retrospective study, including patients admitted to the ED between November 2016 and February 2017. We included patients aged >65 years who were admitted to the ED for any medical problem. The NEWS was calculated at the time of ED admission. The primary outcome was in-hospital mortality.

Results
In total, 3,169 patients were included in this study. Median age was 75 years (interquartile range [IQR], 70 to 80 years), and 1,557 (49.1%) patients were male. The in-hospital mortality rate was 5.1% (161 patients). Median NEWS was higher in non-survivors than in survivors (5 [IQR, 3–8] vs. 1 [IQR, 0–3], P<0.001). Multivariate logistic analysis showed that the NEWS was associated with in-hospital mortality, after adjusting for other confounders. The area under the curve of the NEWS for predicting in-hospital mortality was 0.820 (95% confidence interval, 0.806 to 0.833).

Conclusion
Our results show that the NEWS at admission is associated with in-hospital mortality among patients aged >65 years.

Citations

Citations to this article as recorded by  Crossref logo
  • One Score Fits All? A Narrative Review on Early Warning Scores for Older Adults in the Emergency Department in the Era of Personalized Medicine
    Valeria Maccauro, Piergiacomo Maria Cacciamani Fanelli, Davide Antonio Della Polla, Nicola Bonadia, Giuseppe De Matteis, Andrea Piccioni, Antonio Gasbarrini, Claudio Sandroni, Francesco Franceschi, Marcello Covino
    Journal of Personalized Medicine.2026; 16(2): 98.     CrossRef
  • Comparative prognostic performance of identification of seniors at risk tool and national early warning score for 30-day adverse outcomes in older emergency department patients
    Şakir Hakan Aksu, Fikret Bildik, İsa Kılıçaslan, Ayfer Keleş, Mehmet Ali Aslaner, Ahmet Demircan
    BMC Emergency Medicine.2026;[Epub]     CrossRef
  • Early Warning Scores in Emergency Department Patients Aged 80 Years or Older
    Marcello Covino, Piergiacomo Maria Cacciamani Fanelli, Nicola Bonadia, Valeria Maccauro, Davide Antonio Della Polla, Giuseppe De Matteis, Andrea Piccioni, Antonio Gasbarrini, Claudio Sandroni, Francesco Franceschi
    JAMA Network Open.2026; 9(3): e261532.     CrossRef
  • Development and Internal Validation of a Multivariable Prehospital Prediction Score for Critical Illness Progression and 30-Day Mortality in Non-Traumatic EMS Patients
    Thongpitak Huabbangyang, Chunlanee Sangketchon, Kunpariya Sawetwong, Khitakan Buathong, Chiratchaya Dontri, Yanisa Lakhonwong, Tanarin Nopphakhun, Rapeeporn Rojsaengroeng, Kaiwit Bunta
    Journal of Healthcare Leadership.2026; Volume 18: 1.     CrossRef
  • Assessing Risk of Early ICU Admission or Death at Emergency Department Triage: Clinical Judgment Versus Early Warning Scores
    Nicola Bonadia, Piergiacomo Maria Cacciamani Fanelli, Davide Antonio Della Polla, Valeria Maccauro, Giuseppe De Matteis, Andrea Piccioni, Antonio Gasbarrini, Claudio Sandroni, Francesco Franceschi, Marcello Covino
    Academic Emergency Medicine.2026;[Epub]     CrossRef
  • Early warning scores as indicators of nursing hours in general wards: A cross-sectional analysis of inpatient physiological parameters
    Soohyun Kim, Sung-Hyun Cho, Eunhye Kim
    International Journal of Nursing Studies.2026; 183: 105643.     CrossRef
  • The clinical frailty scale improves risk prediction in older emergency department patients: a comparison with qSOFA, NEWS2, and REMS
    Ho Sub Chung, Yunhyung Choi, Ji Yeon Lim, Keon Kim, Yoon Hee Choi, Dong Hoon Lee, Sung Jin Bae
    Scientific Reports.2025;[Epub]     CrossRef
  • An Evaluation of the National Early Warning Score 2 and the Laboratory Data Decision Tree Early Warning Score in Predicting Mortality in Geriatric Patients
    Kadir Küçükceran, Mustafa Kürşat Ayrancı, Sedat Koçak, Abdullah Sadık Girişgin, Zerrin Defne Dündar, Sami Ataman, Enes Bayındır, Oğuz Karaçadır, İbrahim Tatar, Mustafa Doğru
    The Journal of Emergency Medicine.2024; 66(3): e284.     CrossRef
  • Application of the National Early Warning Score in patients with suspected COVID‐19 in Korea
    Seon Yeong Park, Chun Song Youn, Hyo Joon Kim, Soo Hyun Kim, Sang Hyun Park, Hyo Jin Bang
    Hong Kong Journal of Emergency Medicine.2024; 31(2): 76.     CrossRef
  • Role of the National Early Warning score and Modified Early Warning score for predicting mortality in geriatric patients with non-traumatic coma
    Dong Ki Kim, Dong Hun Lee, Byung Kook Lee
    Heliyon.2024; 10(6): e28338.     CrossRef
  • The efficacy of low molecular weight heparin is reduced in COVID-19
    Oliver Watson, Jun-Cezar Zaldua, Suresh Pillai, Janet Whitley, Matthew Howard, Matthew Lawrence, Karl Hawkins, Keith Morris, Phillip Adrian Evans
    Clinical Hemorheology and Microcirculation.2023; 84(3): 333.     CrossRef
  • Use of illness severity scores to predict mortality in interstitial lung disease patients hospitalised with acute respiratory deterioration
    Rachel L. Williams, Catherine Hyams, Joe Robertshaw, Maria Garcia Gonzalez, Zsuzsa Szasz-Benczur, Paul White, Nick A. Maskell, Adam Finn, Shaney L. Barratt, David Adegbite, Rupert Antico, Francesca Bayley, Beth Begier, Maddalena Bellavia, Emma Bridgeman,
    Respiratory Medicine.2023; 212: 107220.     CrossRef
  • The predictive value of modified soluble urokinase plasminogen activator receptor (suPAR) with National Early Warning Score (NEWS) for mortality in emergency elderly patients in Japan: a prospective pilot study
    Toshiya Mitsunaga, Yuhei Ohtaki, Yutaka Seki, Kunihiro Mashiko, Masahiko Uzura, Kenji Okuno, Satoshi Takeda
    Acute Medicine & Surgery.2023;[Epub]     CrossRef
  • Prediction model of in-hospital mortality in intensive care unit patients with cardiac arrest: a retrospective analysis of MIMIC -IV database based on machine learning
    Yiwu Sun, Zhaoyi He, Jie Ren, Yifan Wu
    BMC Anesthesiology.2023;[Epub]     CrossRef
  • Comparison of Six Scoring Systems for Predicting In-hospital Mortality among Patients with SARS-COV2 Presenting to the Emergency Department
    Benyamin Hoseini, Zahra Rahmatinejad, Hamidreza Reihani, Ameen Abu Hanna, Ali Pourmand, Seyyed Mohammad Tabatabaei, Fatemeh Rahmatinejad, Saeid Eslami
    Indian Journal of Critical Care Medicine.2023; 27(6): 416.     CrossRef
  • A comparison of palliative care and rapid emergency screening (P-CaRES) tool, broad and narrow criteria, and surprise questions to predict survival of older emergency department patients
    Siripan Koyavatin, Shan Woo Liu, Jiraporn Sri-on
    BMC Palliative Care.2023;[Epub]     CrossRef
  • Clinical support system for triage based on federated learning for the Korea triage and acuity scale
    Hansol Chang, Jae Yong Yu, Geun Hyeong Lee, Sejin Heo, Se Uk Lee, Sung Yeon Hwang, Hee Yoon, Won Chul Cha, Tae Gun Shin, Min Seob Sim, Ik Joon Jo, Taerim Kim
    Heliyon.2023; 9(8): e19210.     CrossRef
  • Screening Tool Risk Score Assessment in the Emergency Department for Geriatric (S-TRIAGE) in 28-day mortality
    Praphaphorn Supatanakij, Kanruethai Imok, Karn Suttapanit
    International Journal of Emergency Medicine.2023;[Epub]     CrossRef
  • EARLY PREDICTION OF UNEXPECTED LATENT SHOCK IN THE EMERGENCY DEPARTMENT USING VITAL SIGNS
    Hansol Chang, Weon Jung, Juhyung Ha, Jae Yong Yu, Sejin Heo, Gun Tak Lee, Jong Eun Park, Se Uk Lee, Sung Yeon Hwang, Hee Yoon, Won Chul Cha, Tae Gun Shin, Taerim Kim
    Shock.2023; 60(3): 373.     CrossRef
  • A systematic review of the discrimination and absolute mortality predicted by the National Early Warning Scores according to different cut-off values and prediction windows
    Mark Holland, John Kellett
    European Journal of Internal Medicine.2022; 98: 15.     CrossRef
  • Comparison of Five Triage Tools for Identifying Mortality Risk and Injury Severity of Multiple Trauma Patients Admitted to the Emergency Department in the Daytime and Nighttime: A Retrospective Study
    Youguo Ying, Boli Huang, Yan Zhu, Xiaobin Jiang, Jinxiu Dong, Yanfen Ding, Lei Wang, Huimin Yuan, Ping Jiang, Fahd Abd Algalil
    Applied Bionics and Biomechanics.2022; 2022: 1.     CrossRef
  • National early warning score (NEWS) 2 predicts hospital mortality from COVID-19 patients
    Eric Wibisono, Usman Hadi, Bramantono, Muhammad Vitanata Arfijanto, Musofa Rusli, Brian Eka Rahman, Tri Pudy Asmarawati, Miftahani Leo Choirunnisa, Dwi Retno Puji Rahayu
    Annals of Medicine & Surgery.2022;[Epub]     CrossRef
  • Comparing the prehospital NEWS with in-hospital ESI in predicting 30-day severe outcomes in emergency patients
    Peyman Saberian, Atefeh Abdollahi, Parisa Hasani-Sharamin, Maryam Modaber, Ehsan Karimialavijeh
    BMC Emergency Medicine.2022;[Epub]     CrossRef
  • Performance of the National Early Warning Score in Hospitalized Patients With Kidney Failure on Maintenance Hemodialysis
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Injury & Prevention

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Relationship between age and injury severity in traffic accidents involving elderly pedestrians
Clin Exp Emerg Med. 2019;6(3):235-241.   Published online September 30, 2019
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Relationship between age and injury severity in traffic accidents involving elderly pedestrians
Clin Exp Emerg Med. 2019;6(3):235-241.   Published online September 30, 2019
Close
Objective
This study aimed to examine whether injury severity differs with respect to age among elderly pedestrians involved in traffic accidents and identify factors affecting injury severity.
Methods
Using emergency department-based injury in-depth surveillance data, we analyzed the data of patients aged ≥60 years who were victims of pedestrian traffic accidents during 2011 to 2016. The pedestrians’ ages were divided into 5-year age strata beginning at 60 years. In a multivariate analysis, injury severity was classified as severe to critical or mild to moderate.
Results
The analysis included 10,449 patients. All age groups had a female predominance, and accidents most frequently occurred during the early morning. Multivariate analyses revealed that compared to the 60 to 64 years group, the odds ratios for incurring a severe injury were 1.18 (95% confidence interval [CI], 1.02 to 1.37) for the 65 to 69 years group, 1.42 (95% CI, 1.23 to 1.64) for the 70 to 74 years group, 1.70 (95% CI, 1.45 to 1.98) for the 75 to 79 years group, and 1.83 (95% CI, 1.56 to 2.15) for the ≥80 years group.
Conclusion
In this study of emergency department-based data, we found that injury severity increased with age among elderly victims of traffic accidents. Furthermore, injury severity varied with respect to sex, time and location of the accident, and type of vehicle involved. Therefore, measures intended to reduce and prevent traffic accidents involving elderly pedestrians should consider these findings.

Citations

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Emergency Medical Services

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Differences in youngest-old, middle-old, and oldest-old patients who visit the emergency department
Clin Exp Emerg Med. 2018;5(4):249-255.   Published online December 31, 2018
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Differences in youngest-old, middle-old, and oldest-old patients who visit the emergency department
Clin Exp Emerg Med. 2018;5(4):249-255.   Published online December 31, 2018
Close
Objective
As aging progresses, clinical characteristics of elderly patients in the emergency department (ED) vary by age. We aimed to study differences among elderly patients in the ED by age group.
Methods
For 2 years, patients aged 65 and older were enrolled in the study and classified into three groups: youngest-old, ages 65 to 74 years; middle-old, 75 to 84 years; and oldest-old, ≥85 years. Participants’ sex, reason for ED visit, transfer from another hospital, results of treatment, type of admission, admission department and length of stay were recorded.
Results
During the study period, a total 64,287 patients visited the ED; 11,236 (17.5%) were aged 65 and older, of whom 14.4% were 85 and older. With increased age, the female ratio (51.5% vs. 54.9% vs. 69.1%, P<0.001), medical causes (79.5% vs. 81.3% vs. 81.7%, P=0.045), and admission rate (35.3% vs. 42.8% vs. 48.5%, P<0.001) increased. Admissions to internal medicine (57.5% vs. 59.3% vs. 64.7%, P<0.001) and orthopedic surgery (8.5% vs. 11.6% vs. 13.8%, P< 0.001) also increased. The ratio of admission to intensive care unit showed no statistical significance (P=0.545). Patients over age 85 years had longer stays in the ED (330.9 vs. 378.9 vs. 407.2 minutes, P<0.001), were discharged home less (84.4% vs. 78.9% vs. 71.5%, P<0.001), and died more frequently (6.3% vs. 10.4% vs. 13.0%, P<0.001).
Conclusion
With increased age, the proportion of female patients and medical causes increased. Rates of admission and death increased with age and older patients had longer ED and hospital stays.

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High-sensitivity C-reactive protein/albumin ratio as a predictor of in-hospital mortality in older adults admitted to the emergency department
Clin Exp Emerg Med. 2017;4(1):19-24.   Published online March 30, 2017
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High-sensitivity C-reactive protein/albumin ratio as a predictor of in-hospital mortality in older adults admitted to the emergency department
Clin Exp Emerg Med. 2017;4(1):19-24.   Published online March 30, 2017
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Objective
The objective of this study was to test the hypothesis that an elevated high-sensitivity C-reactive protein (hs-CRP)/albumin ratio at admission increases the risk of mortality in older patients admitted to the hospital via the emergency department (ED).
Methods
We performed a retrospective analysis of patients admitted to the ED with any medical problem between May 2013 and October 2013 who were older than 65 years. The hs-CRP and albumin levels were measured at the time of admission to the ED. The primary outcome was all-cause in-hospital mortality. Multivariate logistic analysis was performed.
Results
A total of 811 patients were finally included in this study. The mean age was 76±7 years, and 438 subjects (54%) were male. The in-hospital mortality rate was 9.0% (73 patients). The hs-CRP/albumin ratio was higher in nonsurvivors than in survivors (34.2±37.6 vs. 16.2±25.5, P<0.001). Multivariate logistic analysis showed that the hs-CRP/albumin ratio was associated with all-cause in-hospital mortality after adjusting for other confounding factors (odds ratio, 1.011; 95% confidence interval [CI], 1.003 to 1.020). The prognostic value of the hs-CRP/albumin ratio for predicting mortality (area under the curve, 0.728; 95% CI, 0.696 to 0.758) was greater than that of hs-CRP alone (area under the curve, 0.706; 95% CI, 0.674 to 0.738; P<0.001).
Conclusion
The hs-CRP/albumin ratio at admission to the ED is associated with all-cause in-hospital mortality among patients older than 65 years. The hs-CRP/albumin ratio may serve as a surrogate marker of disease severity.

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