Objective: To determine the frequency of the diagnosis of NSAP among elderly patients discharged from EDs, investigate short-term outcomes and look for factors related to adverse outcomes. OUTCOME MEASURES AND ANALYSIS: We included all patients 65 years or older diagnosed with NSAP and discharged home after ED care in 52 Spanish EDs during a one-week period. Outcomes consisted of 7-day and 30-day all-cause death, 30-day ED reconsultation and hospitalization, and 30-day combined adverse events (AEs) (ED reconsultation, hospitalization or death).

Main results: Among 25,557 elderly patients attended in EDs during the 1-week period, 19,026 were discharged home and 397 (2.1 %) had NSAP as the final diagnosis. The 7-day and 30-day mortality were 0. 3% and 1.5 %, respectively. The 30-day ED reconsultation was 21.9 % and the 30-day hospitalization was 16.4 %. Thirty-day combined AEs were recorded in 22.9 % of patients and were independently associated with comorbidity and functional impairment (Barthel index <100 points; 2.35, 1. 24-4.45), as well the use of opiate (3.25, 18-8.93) and non-opiate analgesia (1.77,0.101-(powers guertler, 1995 3).11), lack laboratory (1.91, 1.02-(powers 3).58) imaging studies in ed during index episode. age, sex extended observation were not associated with risk aes.

Conclusions: A diagnosis of NSAP at ED discharge is frequent in elderly patients and carries a risk of adverse short-term outcomes. ED discharge of elderly patients with NSAP should be cautious, especially in comorbid patients with limited functional capacity, those needing analgesia, and patients discharged without laboratory and imaging studies.