Journal of Clinical Nursing

Factors Associated With the Survival of Older Patients With Pneumonia in the Emergency Department: A Retrospective Observational Study

ABSTRACT

Aims

To determine the clinical characteristics and identify not only the Korean Triage and Acuity Scale levels of older patients with pneumonia in the emergency department but also the factors associated with their survival.

Design

This study employed a retrospective observational design.

Methods

This study was conducted at the emergency department of a university hospital in Seoul, South Korea. It utilised medical data from January 1 to December 31, 2023. The study sample comprised 327 patients aged 65 years or older who received a pneumonia diagnosis (International Classification of Diseases: J10–J18). Binary logistic regression analysis was performed to identify independent factors associated with their survival.

Results

Survival was significantly associated with and influenced by sex (specifically, male sex), initial Korean Triage and Acuity Scale level, oxygen supplementation in the emergency department, consciousness level (specifically, painful response), body temperature (> 37.5°C) and a diagnosis of solid or hematologic malignancies.

Conclusions

The findings highlight the need for improved triage protocols, emphasising consciousness level, body temperature and malignancies. Incorporating geriatric-specific age thresholds and oncologic status into Korean Triage and Acuity Scale classifications may enhance risk stratification, timely intervention and resource allocation in emergency department settings.

Implications for the Profession and/or Patient Care

This study provides insight into triage accuracy for older pneumonia patients, emphasising early recognition of high-risk individuals and strengthening nursing assessment protocols. Improved Korean Triage and Acuity Scale classifications can optimise resource allocation and emergency care strategies, ultimately reducing mortality rates.

Impact

The study provides actionable insights for emergency nurses, triage clinicians and policymakers. The findings support the refinement of KTAS protocols to enhance risk stratification and guide resource allocation for older pneumonia patients, ultimately aiming to reduce mortality rates.

Reporting Method

Adhered to STROBE guidelines for observational studies.

Patient or Public Contributions

Although patients did not directly participate, the findings advocate for patient-centred triage improvements, enhancing early identification of high-risk older patients with pneumonia.