Summary

Use of Diagnostic Tests in Older Adults Living in Nursing Homes: The EDEN-41 Cohort Study adjusted by Propensity Score Matching

Elena Fuentes¹, Javier Jacob¹, Aitor Alquézar², Juan González del Castillo³, Francisco Javier Montero-Pérez⁴, Eric Jorge García-Lamberechts⁵, Cesáreo Fernández-Alonso⁶, Guillermo Burillo-Putze⁷, Pascual Piñera⁶, Nieves López-Delmas¹, Lara Guillén-García¹, Sira Aguiló⁷, Pere Llorens⁸, Òscar Miró⁷, en representación de los investigadores de la red SIESTA

Affiliation of the authors

¹Servicio de Urgencias, Hospital Universitari de Bellvitge, Universitat de Barcelona (UB), Procesos Urgentes y Emergentes IDIBELL. L’Hospitalet de Llobregat, Barcelona, Spain. ²Servicio de Urgencias, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. ³Servicio de Urgencias, Hospital Clínico San Carlos, IDISSC, Universidad Complutense, Madrid, Spain. ⁴Servicio de Urgencias, Hospital Reina Sofía, Córdoba, Spain. ⁵Departamento de Medicina Física y Farmacología, Universidad de La Laguna, Tenerife, Spain. ⁶Servicio de Urgencias, Hospital Reina Sofía, Murcia, Spain. ⁷Área de Urgencias, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain. ⁸Servicio de Urgencias, Unidad de Estancia Corta y Hospitalización a Domicilio, Hospital Doctor Balmis, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Universidad Miguel Hernández, Alicante, Spain.

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Fuentes E, Jacob J, Alquézar A, González del Castillo J, Montero-Pérez FJ, García-Lamberechts EJ, Fernández-Alonso C, Burillo-Putze G, Piñera P, López-Delmas N, Guillén-García L, Aguiló S, Llorens P, Miró O, en representación de los investigadores de la red SIESTA. Use of Diagnostic Tests in Older Adults Living in Nursing Homes: The EDEN-41 Cohort Study adjusted by Propensity Score Matching. Rev Esp Urg Emerg. 2026;5:92–8

Summary

OBJECTIVE. This study investigates the characteristics and use of diagnostic tests in patients aged ≥ 65 years living in nursing homes who present to hospital emergency departments (EDs) for any reason.
MATERIALS AND METHODS. We conducted a retrospective, multicenter observational study using data from the EDEN (Emergency Department and Elder Needs) cohort. A total of 52 Spanish EDs participated, including all patients aged $ 65 years who were treated for any reason for a 1-week period in April 2019. Demographic data, baseline characteristics, and use of diagnostic tests were collected. Patients were stratified according to their place of residence (nursing home vs private home). Crude analyses were performed in the overall cohort, followed by adjusted analyses in 2 patient subgroups matched using propensity score matching with respect to the use of diagnostic tests in the ED. Odds ratios (ORs) with 95 % confidence intervals (CIs) were calculated for patients living in nursing homes.
RESULTS. A total of 23,629 patients were analyzed; the vast majority, 22,060 (93.4 %), lived in private homes, while 1,569 (6.6 %) lived in nursing homes. Nursing home residents had more comorbidities, poorer baseline functional status, and a higher prevalence of geriatric syndromes. They underwent more blood tests, conventional radiography, electrocardiograms, and microbiological cultures, but not more ultrasound examinations or invasive procedures. Propensity score matching generated 2 groups of 1,029 patients each with similar characteristics. In this matched analysis, living in a nursing home was associated with greater use of blood tests (OR, 1.278; 95 % CI, 1.043–1.565), conventional radiology (OR, 1.336; 95 % CI, 1.098–1.627), and microbiological cultures (OR, 1.347; 95 % CI, 1.077–1.686), but not with the performance of electrocardiography, ultrasound, or invasive procedures.
CONCLUSIONS. Living in a nursing home is associated with increased use of diagnostic tests among adults aged $ 65 years, which may generate higher costs, increased workload, and additional risks for this patient population.