The evaluation of mental status of elderly patients presenting to emergencyservices and the comparison between the last diagnosis and their complaints

Abstract

Introduction: The number of geriatric patients presenting to the emergency departmentincreases every year. In addition, it is known that the mental status of geriatric patients maydeteriorate as they age. In the emergency department, one of the main premises of patientmanagement is anamnesis. However, impairments in mental status of geriatric patients decreasethe reliability of anamnesis. In this study, we aimed to determine the mental status of elderlypatients who presented to the emergency department, the relationship between mental statusand patients complaints, and last diagnoses and mortality. Materials and Methods: The study was planned to be prospective. The mental status of geriatricpatients who presented to the emergency department was evaluated with a six-questionscreening test. Complaints, final diagnosis information, hospitalization department, duration ofhospitalization, judicial status and mortality information were recorded. Consistency betweenpatients complaints and symptoms determined in physician examination was evaluated.Symptom-finding consistency levels based on mental status were compared. Kappa tests forconsistency assessments and chi-square test for intergroup comparisons were used.Findings: The match between patient complaints and final diagnosis of 755 patients wasevaluated by two independent specialist physicians. As a result of the six-question screeningtest, a mismatch between patient complaint and final diagnosis was found in 16.2% of 204patients with abnormal screening tests (n=33) compared to 0.4% of 551 patients, who had anormal screening test (n=2). Mortality was found to be 9.8% in patients with abnormal testresults while it was found to be 2.0% in patients with normal screening tests.Conclusion: Mental status variance determined in elderly patients appears to be a risk factorin terms of mortality. Complaints in geriatric patients having mental status variance can bedeceptive in terms of pointing to the current disease. Exploring this relationship in detail withfurther studies should be considered, in order to make a significant contribution to the service