Emerg Radiol. 2025 Dec 4. doi: 10.1007/s10140-025-02418-2. Online ahead of print.
ABSTRACT
PURPOSE: Older adult self-neglect, the inability to perform essential self-care, is an emerging public health problem. We aimed to evaluate imaging utilization and outcomes of patients with self-neglect compared to matched controls.
METHODS: This IRB-approved retrospective study, conducted at two major academic medical centers, utilized the enterprise data warehouse to identify patients of > 60 years receiving a self-neglect mandate in the emergency department (ED) during 2019. Our study cohort consisted of 108 cases and 108 matched controls by age, gender, race, and time of ED presentation.
RESULTS: During the index visit, cases had significantly higher imaging utilization (p < 0.001). Revisit and readmission rates over the 5-year study period were significantly higher among cases (526 versus 290 revisits (p < 0.001) and 254 versus 88 readmissions (p < 0.001)), with increased imaging utilization on follow-up for CT (p < 0.0001), X-ray (p < 0.0001), US (p < 0.0001), and MRI (p = 0.003). There were 44 deaths among cases versus 7 among controls. Subgroup analysis revealed that noncompliant cases had significantly higher CT use and an elevated mortality risk over the 5-year study period (both p = 0.02). Significantly higher number of cases lived alone (p < 0.001), had a higher substance use (p = 0.044), and had a higher prevalence of psychiatric illness (p < 0.001).
CONCLUSIONS: Older adult self-neglect patients experience increased ED revisits/readmissions and use more imaging services yet exhibit poorer clinical outcomes, particularly those who do not adhere to discharge recommendations. Identifying at-risk patients and implementing early interventions can mitigate healthcare burdens and improve patient outcomes.
PMID:41339981 | DOI:10.1007/s10140-025-02418-2
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