Impact of COVID-19 state-wide lockdown on older adult presentations to Queensland emergency departments

Cassanne  Eccleston; Elizabeth J Marsden; Alison Craswell; Amy  Sweeny; Naomi Howell; Marianne Wallis; Julia Crilly

doi:10.1111/1742-6723.14236

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Impact of COVID-19 state-wide lockdown on older adult presentations to Queensland emergency departments

Journal article

Peer reviewed

Impact of COVID-19 state-wide lockdown on older adult presentations to Queensland emergency departments

Cassanne Eccleston, Elizabeth J Marsden, Alison Craswell, Amy Sweeny, Naomi Howell, Marianne Wallis and Julia Crilly

Emergency Medicine Australasia, Vol.35(5), pp.799-808

2023

DOI: https://doi.org/10.1111/1742-6723.14236

PMID: 37160322

Appears in COVID-19 Research

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Abstract

cohort study

COVID-19

emergency care

emergency department

older adult

Objective: To determine the impact of the COVID-19 state-wide lockdown on ED presentations for older adults in Queensland, Australia. Methods: A retrospective cohort study pertaining to adults aged 70+ years who presented to Queensland public hospital EDs across three separate time periods; 11 March to 30 June 2018 and 2019 (pre-pandemic average), 2020 (COVID-19 state-wide lockdown) and 2021 (post-state-wide lockdown). The primary outcome was change in presentation rates to ED. Secondary outcomes included change in triage category rates, length of stay (LOS), diagnosis and disposition. Results: There was 380 854 older adult presentations. During the COVID-19 state-wide lockdown, ED presentation rates decreased by 12.5% (incidence rate ratio 0.875 [95% confidence interval 0.867-0.883]). All triage category presentation rates decreased, as did ED LOS and reasons for presentation, except sepsis and disorders of the nervous system. In the post-state-wide lockdown period a 22% (incidence rate ratio 1.22 [95% confidence interval 1.21-1.23]) increase in the presentation rate was observed and presentations in all triage categories increased. ED LOS increased to longer than pre-pandemic (P < 0.001). Respiratory presentations increased by 346%. Patients who 'did not wait' increased by 212% and ED mortality rose by 42% compared to during the lockdown. Conclusion: There was a significant decrease in presentation rates to EDs during the COVID-19 state-wide lockdown for the older population, followed by an increase in presentation rates, longer ED LOS, and an increased ED mortality rate, in the post-state-wide lockdown period. It is important to ensure older adults continue to seek appropriate, timely medical care, during a pandemic.

Details

Title: Impact of COVID-19 state-wide lockdown on older adult presentations to Queensland emergency departments
Authors: Cassanne Eccleston (Corresponding Author) - Sunshine Coast University Hospital
Elizabeth J Marsden (Author) - University of Queensland
Alison Craswell (Author) - University of the Sunshine Coast, Queensland, School of Health - Nursing
Amy Sweeny (Author) - Gold Coast Health
Naomi Howell (Author) - University of the Sunshine Coast, Queensland, School of Health - Nursing
Marianne Wallis (Author) - Southern Cross University
Julia Crilly (Author) - Griffith University
Publication details: Emergency Medicine Australasia, Vol.35(5), pp.799-808
Publisher: John Wiley & Sons, Inc.
Date published: 2023
DOI: 10.1111/1742-6723.14236
ISSN: 1742-6723
PMID: 37160322
Grant note: EMSF-008COV-2020/ Emergency Medicine Foundation
Organisation Unit: School of Health - Nursing; School of Nursing, Midwifery and Paramedicine - Legacy; University of the Sunshine Coast, Queensland
Language: English
Record Identifier: 99725898502621
Output Type: Journal article

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Collaboration types: Domestic collaboration
Web Of Science research areas: Emergency Medicine