Facteurs prédictifs de consultations répétées aux urgences chez les personnes âgées de plus de 65 ans

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Publiée Dec 25, 2017
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Vol. 95 No 5 (2017): Revue mai 2017

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Hanen Ghazali
Rania Jebri
Anware Yahmadi
Najla El Heni
Ines Chermiti
Sami Souissi

Résumé

Introduction : L’identification des facteurs prédictifs de consultations répétées aux urgences chez les personnes âgées peut améliorer leur qualité de vie et réduire la demande de soins.
Objectif : Evaluer les facteurs prédictifs de consultations répétées aux urgences chez les personnes âgées de plus de 65 ans.
Méthodes : Etude prospective menée sur un mois. Inclusion : patients (âge ≥ 65ans) vus et sortants le même jour des urgences. Recueil des caractéristiques épidémio-cliniques des patients à la 1ère consultation (consultation index(CI)). Utilisation du questionnaire (Identification of Senior At Risk) ISAR pour évaluer les patients.Estimation du nombre de reconsultation (n ≥ 2) aux urgences dans les 30 jours suivant la CI   par contact téléphonique.
Résultats : Inclusion de 125 patients. Age moyen= 76 +/-7 ans. Sex-ratio = 0 ,85. Trente et un  patients (25%) ont re-consulté aux urgences. A l’analyse univariée: l’âge > 75 ans, score ISAR >2, antécédent d’insuffisance rénale, consultation aux urgences dans le mois précédent la CI ou hospitalisation dans les 6 derniers mois, patients dépendants d’une aide au domicile (AD) et prise de plus de 3 médicaments par jour étaient significativement liés à une consultation répétée aux urgences. A l’analyse multivariée : la consultation aux urgences dans le mois précédent la CI, l’hospitalisation dans les 6 derniers mois  et les patients dépendants d’une AD étaient indépendamment associés à une consultation répétée aux urgences.
Conclusion : L’identification des patients âgés à risque de re-consultations est importante pour améliorer leur prise en charge.

Mots-clés :

personnes âgées, services des urgences, consultations répétées, ISAR

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