Age Ageing. 2026 Jun 1;55(6):afag180. doi: 10.1093/ageing/afag180.
ABSTRACT
BACKGROUND: The Emergency Department (ED) is a ‘strategic crossroads’ for geriatric care, as older adults represent nearly 50% of ED visits resulting in hospital admissions. It is therefore essential to integrate geriatric expertise within the ED to address their complex needs and improve outcomes.
AIMS: This study evaluated whether implementing a Geriatric Team (GT) comprising geriatricians, nurses, social workers, tasked with conducting Comprehensive Geriatric Assessment and delivering tailored interventions in the ED, could reduce unnecessary hospital admissions and repeated ED visits compared to standard practice.
MATERIALS AND METHODS: A multicentre, parallel, unblinded, superiority randomised study was conducted on people aged 75 years or older who scored ≥2 on the Triage Risk Stratification Tool upon ED admission. Randomisation was computer-generated and applied to calendar weeks. The primary outcome was hospital admission at the index ED visit. The secondary outcomes were ED readmissions; hospitalisations; mortality at 7, 30 and 90 days; and functional status at 30 and 90 days.
RESULTS: The study included 624 participants, 314 (50.3%) in the GT group and 310 (49.7%) in the usual care group. Hospital admissions at the index ED visit were 13.7% in the GT and 56.8% in the usual care group. ED readmission and hospitalisation rates were similar across groups. All-cause 30-day mortality was similar across groups, while 90-day mortality was lower in the intervention group. Functional decline was attenuated at both 30 and 90 days in the GT group.
CONCLUSIONS: By relieving pressure on inpatient services, the GT integration into ED workflows represents a scalable strategy for health systems facing demographic shifts and rising demand for age-sensitive care.
PMID:42348848 | DOI:10.1093/ageing/afag180
