急診高齡者之負向健康結果

Adverse Outcomes of Geriatric Patients Visiting Emergency Department

本文應用範域文獻回顧方式探討急診高齡者之高危險負向健康結果的相關概念及研究現況。採系統性文獻回顧法，收錄年限至2021年發表於PubMed、Embase、Cochrane之期刊文獻，篩選納入14篇文獻分析。經彙整結果發現：（一）文章多發表於歐美國家、（二）急診高齡者之高危險負向健康結果指標，包含：急診再返、住院、入住機構、死亡和功能衰退、（三）14篇期刊文獻有5種篩檢工具，面向包含：日常生活活動功能、認知功能、住院史、多重用藥、跌倒史、外傷和支持系統等，然目前尚無通用的黃金標準。建議未來可參考本範域文獻回顧結果，同時考量台灣急診高齡者的就醫習性和醫療保險制度等，擬定適切台灣本土性之急診高齡者高危險負向健康結果篩檢工具。

This scoping review was designed to provide a deeper understanding of the overall phenomenon and the researches of high risk adverse outcomes in older patients attending emergency department. A systematic review method was used to analyze researches retrieved from electronic databases including PubMed, Embase, and Cochrane Library. After screening for topic relevance and deleting repetitions, 14 articles were selected for further analysis. The key findings of the review included the followings: (1) The researches were mostly published in European and American countries; (2) The indicators of high-risk adverse outcomes in older patients attending emergency department, including: unscheduled revisits to the emergency department , hospitalization, admission to nursing home, functional decline and death; (3) A total of 14 researches included 5 screening tools and the dimensions of these tools were: activities of daily living, cognitive function, pre-hospitalization history, polypharmacy, history of falls, trauma, support system, etc. However, there is no gold standard screen tools from previous researches. Combining the culture of seeking health care service and insurance in Taiwan, this scoping review approach may assist further development of appropriate screening tool for high-risk adverse outcomes in older patients attending emergency department in Taiwan.