Use of emergency department discharge data for the surveillance of injuries among older adults

Purpose: Hospital discharge data are accepted as standard information for injury surveillance. While these data are useful for determining leading causes, assessing need, and estimating burden, they only capture more serious injuries. Surveillance using ED discharge data therefore gives insight into less serious injuries. The purpose of this study is to examine and discuss injuries sustained by older adults who were treated and discharged from the ED.

Methods: The study population included patients aged 55+ who were treated and discharged from a San Diego County ED with an injury from 2006-2007. Injuries were identified by E-code. Descriptive analyses were conducted and population rates calculated.

Results: During 2006*, there were 127,994 patients aged 55+ who were treated and discharged from the ED. Of these, 30,463 (24%) had a reported E-code. Overall, the rate of discharge from the ED with an injury was 4,907 per 100,000. Falls were the most common mechanism overall (49%). The most common type of fall was slipping, tripping or stumbling. Among patients aged 65+, ED discharge for an overdose or poisoning was common, especially among 75 to 84 year-olds (519 per 100,000). Overall, one out of every four patients had an open wound, and one out of every five had a fracture.

Conclusions: The results of this study indicate a significant use of the ED for injuries sustained by older adults. Assessing injury trends among ED discharges offers the opportunity to assist in developing targeted intervention plans to prevent future injuries.