Atención de la persona mayor en los servicios de urgencias: complejidad clínica, impacto organizativo y necesidad de adaptación geriátrica integral
Resumen
Introducción: el progresivo envejecimiento poblacional está incrementando de forma sostenida la demanda de atención de personas mayores en los servicios de urgencias, un entorno tradicionalmente diseñado para resolver procesos agudos y de rápida resolución. Este fenómeno plantea desafíos clínicos y organizativos que requieren estrategias específicas de adaptación.
Objetivos: describir la complejidad clínica de las personas mayores atendidas en los servicios de urgencias, su impacto sobre la organización asistencial y las principales necesidades de adaptación identificadas en la literatura.
Metodología: se realizó una revisión narrativa de la literatura con enfoque descriptivo. Se efectuó una búsqueda en las bases de datos PubMed, SciELO y LILACS de artículos publicados entre 2020 y 2025 en español o inglés sobre. Se incluyeron revisiones y estudios observacionales que abordaran aspectos clínicos, organizativos o asistenciales. Tras el proceso de selección se incluyeron 11 artículos, complementándose mediante revisión de referencias bibliográficas y artículos citantes.
Resultados: las personas mayores presentan características diferenciales, con frecuencia fragilidad, multimorbilidad, polifarmacia y deterioro cognitivo, condiciones que dificultan el triaje, el diagnóstico y la toma de decisiones clínicas. Esta complejidad se asocia a mayores tasas de hospitalización, estancias prolongadas, deterioro funcional, eventos adversos y reconsultas. Asimismo, genera un impacto relevante en la organización de los servicios, incrementando la carga asistencial, la utilización de recursos y el riesgo de sobrecarga, estrés y fatiga decisional entre los profesionales sanitarios. La evidencia revisada señala beneficios potenciales de estrategias como el triaje geriátrico, la valoración geriátrica integral, la coordinación interdisciplinaria y la capacitación específica/especializada del personal.
Conclusiones: la atención de personas mayores en urgencias constituye un desafío creciente que requiere modelos asistenciales adaptados a sus necesidades. La incorporación de estrategias específicas podría mejorar la calidad de la atención, optimizar los resultados en salud y favorecer entornos de trabajo más seguros, eficientes y centrados en la persona.
Citas
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