Evidence map›Paper›PMID 40335863›Full record

ArticleEuropean geriatric medicine2025

Evaluation of a care pathway for older adults presenting with nonspecific complaints at the emergency department: a before-and-after study.

M G A M van der Velde, M A C Jansen, F Derkx-Verhagen, I P B Tournoij, F S Jonkers, H R Haak, M N T Kremers

Abstract read
In one paragraph

Article in European geriatric medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

M G A M van der VeldeDepartment of Internal Medicine, Máxima MC, De Run 4600, 5504 DB, Veldhoven, The Netherlands. marleen.van.der.velde@mmc.nl.ORCID http://orcid.org/0000-0001-5903-2371
M A C JansenNetwerk Acute Zorg Brabant, Tilburg, the Netherlands.
F Derkx-VerhagenEmergency Department, Máxima MC, Veldhoven, the Netherlands.
I P B TournoijDepartment of Geriatrics, Anna Hospital, Geldrop, the Netherlands.
F S JonkersDepartment of Internal Medicine, Máxima MC, De Run 4600, 5504 DB, Veldhoven, The Netherlands.
H R Haak *Department of Internal Medicine, Máxima MC, De Run 4600, 5504 DB, Veldhoven, The Netherlands.ORCID http://orcid.org/0000-0001-7385-9359
M N T Kremers *Department of Health Services Research, and CAPHRI School for Public Health and Primary Care, Aging and Long Term Care Maastricht, Maastricht, the Netherlands.ORCID http://orcid.org/0000-0002-3791-8961

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeManaging older patients presenting at the Emergency Department (ED) poses challenges due to their predisposition to present with nonspecific complaints (NSC). With an ageing population and ED overcrowding, significance of NSC is expected to grow. Therefore, we implemented a structured care pathway to address the complexity of NSC presentations. The aim of this study is to evaluate the effectivity of this care pathway.

methodsWe conducted a before-and-after study to evaluate the NSC care pathway, which included risk stratification, standardized assessment and diagnostic measurements. A control group receiving standard care was established in two hospitals (hospital 1 and 2) before implementation. Patient enrollment occurred from April 2021 to November 2024. Outcomes included length of stay in the ED (LOS-ED) and in hospital (LOS-H), revisits, diagnostic completeness (i.e. 100% agreement between all ED and hospital discharge diagnoses) and perceived quality of care.

resultsIn total, 164 control and 235 intervention patients were included in this study. Median LOS-ED and LOS-H did not show significant differences between the control and intervention patients. Implementation of the care pathway showed non-significant trends towards improved diagnostic completeness (47.1% vs 37.2%, p = 0.096). This might be associated with the non-significant observed decrease in 30-day readmissions (7.5% vs. 12.7%, p = 0.256). Patient-reported outcomes indicated a positive experience with the quality of care.

conclusionThe care pathway did not improve LOS-ED and LOS-H as hypothesized, possibly due to logistical barriers and patient variability. However, trends suggested improved diagnostic completeness and fewer 30-day readmission rates. Further research initiatives are needed to enhance patient outcomes and care for NSC patients. TRIAL REGISTRY NUMBER: NL8960, date 9-10-2020.

Indexed as

Critical PathwaysEmergency Service, HospitalAgedAged, 80 and overControlled Before-After StudiesFemaleHumansLength of StayMalePatient ReadmissionQuality of Health CareCare pathwayEmergency medicineNonspecific complaintsOlder adults

Identifiers

PMID40335863
PMCPMC12378488

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.