Emergency department use by centenarians: the 2008 Nationwide Emergency Department Sample

INTRODUCTION: Older adults have higher rates of emergency department use than do younger adults, and the number of centenarians is expected to increase. The objective of this study was to examine centenarians' use of the emergency department in the United States, including diagnoses, charges, and disposition.

METHODS: The 2008 Nationwide Emergency Department Sample, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality provided encounter-level data on emergency department visits and weights for producing nationwide estimates. From this data set, we collected patient characteristics including age, sex, primary diagnosis, and disposition. We used χ(2) tests and t tests to test for significant differences among people aged 80 to 89, 90 to 99, and 100 years or older.

RESULTS: Centenarians had a lower rate of emergency department use than those aged 90 to 99 (736 per 1,000 vs 950 per 1,000; P < .05). We found no significant difference in use between centenarians and those aged 80 to 89. The most common diagnoses for centenarians were superficial injuries (5.8% of visits), pneumonia (5.1%), and urinary tract infections (5.1%). Centenarians were more likely to visit the emergency department for fall-related injuries (21.5%) than those aged 80 to 89 (14.1%; P < .05) and 90 to 99 (18.7%; P < .05). Centenarians were more likely to die in the emergency department (2.0%) than were those aged 80 to 89 (0.6%; P < .05) and 90 to 99 (0.7%; P < .05).

CONCLUSION: Centenarians in emergency departments in the United States have different diagnoses, conditions, and outcomes than other older Americans.