Robustness Predictive Factors in People Aged Over 75 Years After Going to the Emergency Room (ROB-U)

Study Overview
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Brief Summary
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After emergency room visits, the elderly patients can increase their dependence and functional decline. In this context the goal of this study is to demonstrate that there are robustness predictive factors after visit to the emergency room.

Detailed Description
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The emergency department is one of the main access routes to the hospital for elderly patients. Older age is often associated with an increase risk of longer stay in the emergency room with a high subsequent risk of hospital re-admission. One of the essential care objectives when treating these patients is to maintain the autonomy to avoid any dependence in order to keep the quality of life, and limit the time of hospitalization. Emergency room visits and hospitalizations are too often considered as a source of autonomy loss aggravation in the elderly. Many studies have demonstrated the mortality predictive factors existence, functional decline, or re-hospitalization of the elderly after an emergency room visit or after hospitalization. No study until now has investigated the existence of factors directly predictive of robustness. Then the goal of this study is to demonstrate that there are robustness predictive factors after going to the emergency room.

Official Title
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Study of the Robustness Predictive Factors in People Aged Over 75 Years After Going to the Emergency Room

Conditions
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Aging, Emergency Room, Risk Factors

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients admitted to the emergency room Patients aged ≥ 75 years old Patients without cognitive disorders or vigilance disorders Patients living at home Patients able to give its non-opposition Non inclusion Criteria: Patients admitted to the hospital in the last 3 months Patients refusing to participate in the study Exclusion Criteria: Patients whose stay is < 14h or > 48h Patients who die during hospitalization Patient not hospitalized Patient not returning home after discharge from hospital

Ages Eligible for Study
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Minimum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Identification of predictive factors of robustness : Autonomy level at home (ADL score) | ADL self-performance coding ranges from 0 (independent) to 4 (total dependence). | 3 months | 
| Identification of predictive factors of robustness by a questionnaire (help at home) | Need of help at home such as : toilet, breakfast, lunch, dinner (yes or not) | 3 months | 
| Identification of predictive factors of robustness by a questionnaire (family visits) | Number of family visits | 3 months | 
| Identification of predictive factors of robustness by a questionnaire (appetit) | loss of appetite (yes or not) | 3 months | 
| Identification of predictive factors of robustness (heart rate) | Heart rate during hospitalization (minimum and maximum values) | 3 months | 
| Identification of predictive factors of robustness (Modified Triage Risk Screening Tool (TRST)) score | The TRST score is a tool to predict repeat emergency department visits and hospitalizations in older patients discharged from the emergency department; This tool evaluates 5 dimensions : cognitive disorders presence, walking disorders, polymedication, hospitalization antecedents and functional assessment (loss of autonomy). Every dimension is worth 1 point if the patient presents the disorder. The final maximum score is 5 points. | 3 months | 
| Identification of predictive factors of robustness : BMI (Body Mass Index) | Body mass index | 3 months | 
| Albuminemia | Rate of Albuminemia | 3 months | 
| Identification of predictive factors of robustness : Lifestyle | Lifestyle: person living alone (yes or not) | 3 months | 
| Sleep assessment using a Visual Analog Scale (VAS). | This scale allows patients to assess their fatigue. The patients locate their fatigue intensity on a 100-millimeters horizontal line. Using a ruler, the score is determined by measuring the distance (mm) on the 10-cm line between the no pain anchor and the patient's mark, providing a range of scores from 0-100. A higher score indicates greater pain intensity. | 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rate of re-hospitalization | Only direct re-hospitalizations in emergency rooms and geriatric short stay will be counted | 3 months | 
| Rate of patient survival | Rate of patient survival | 3 months | 
| Rate of lack of Institutionalization | Rate of lack of Institutionalization | 3 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Elderly dependence, Emergency room visits, Lack of autonomy, Robustness, Re-hospitalization