The Evaluation of Mental Status of Elderly Patients Presenting to Emergency Services and the Comparison Between the Last Diagnosis and Their Complaints

Introduction: The number of geriatric patients presenting to the emergency department increases every year. In addition, it is known that the mental status of geriatric patients may deteriorate as they age. In the emergency department, one of the main premises of patient management is anamnesis. However, impairments in mental status of geriatric patients decrease the reliability of anamnesis. In this study, we aimed to determine the mental status of elderly patients who presented to the emergency department, the relationship between mental status and patients’ complaints, and last diagnoses and mortality.

Materials and Methods: The study was planned to be prospective. The mental status of geriatric patients who presented to the emergency department was evaluated with a six-question screening test. Complaints, final diagnosis information, hospitalization department, duration of hospitalization, judicial status and mortality information were recorded. Consistency between patients’ complaints and symptoms determined in physician examination was evaluated. Symptom-finding consistency levels based on mental status were compared. Kappa tests for consistency assessments and chi-square test for intergroup comparisons were used.

Findings: The match between patient complaints and final diagnosis of 755 patients was evaluated by two independent specialist physicians. As a result of the six-question screening test, a mismatch between patient complaint and final diagnosis was found in 16.2% of 204 patients with abnormal screening tests (n=33) compared to 0.4% of 551 patients, who had a normal screening test (n=2). Mortality was found to be 9.8% in patients with abnormal test results while it was found to be 2.0% in patients with normal screening tests.

Conclusion: Mental status variance determined in elderly patients appears to be a risk factor in terms of mortality. Complaints in geriatric patients having mental status variance can be deceptive in terms of pointing to the current disease. Exploring this relationship in detail with further studies should be considered, in order to make a significant contribution to the service provided to this patient group