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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
url
https://doi.org/10.1111/1742-6723.14236View
Published Version

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.

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Emergency Medicine
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