Summary

Background: With an aging population, healthcare of the elderly population is becoming increasingly important, however, the principles of geriatric medicine and issues of concern specific to geriatric otolaryngologic patients have not been widely applied.

Objectives: To qualitatively analyze otolaryngological (ENT) emergencies in a geriatric population in an ENT emergency department (ED).

Methods: In this retrospective study the medical records of patients ≥ 65 years of age who attended our ENT-ED between 3 pm and 8 am and who were observed and/or treated by the on-call otorhinolaryngologist at Sheba Medical Center in 2009 were reviewed for age, gender, main complaint, and preliminary diagnosis. Allergic reactions, balance disorders, epistaxis, head/facial trauma and swallowing-related complaints were considered true emergencies.

Results: The staff in the ENT-ED examined and treated 1–10 geriatric patients daily (mean 2.35). A total of 597 subjects met the study entry criteria (median age 75 years); 16.6% were ≥ 85 years old. There was approximately equal gender representation. More elderly patients presented to the ENT-ED on the weekends (37.9% of the total) compared to weekdays (62.1%). There were 393 patients (65.8%) with true emergencies, of which epistaxis, balance disorders and head and facial trauma were the most common diagnoses (20.1%, 15.75% and 13.7%, respectively), while 46.5% of all vestibulopathy cases involved benign paroxysmal positional vertigo.

Conclusions: More than 65% of visits of the elderly presenting to ENT-ED involve true emergencies. This growing population may benefit from the presence of geriatric specialists in emergency departments.