Etomidate for procedural sedation in the elderly: a retrospective comparison between age groups

ObjectiveThe objective of the study was to compare the complication rate and length of stay (LOS) between the elderly (65 years and older) and the adult (18-64 years old) populations when etomidate is used for procedural sedation in the emergency department (ED).MethodsA retrospective analysis was performed. Electronic medical records selected all patients who received etomidate in the ED from June 2004 to June 2008. Patients younger than 18 years and those who were intubated were excluded. To account for correlated errors, only first-time visits to the ED were used.ResultsThere were 31 (16%) patients who experienced a complication: 9 (20%) elderly patients compared with 22 (14.8%) adult patients. No significant difference existed between the age groups and adverse effects. The adult mean LOS was 205 minutes, and the elderly LOS was 225 minutes. There was no significant difference between age groups and adverse effects when compared with LOS. Among patients who experienced a complication, mean LOS was 267 minutes: 252 minutes in the elderly age group and 273 minutes in the adult. Among patients who did not experience a complication, the mean LOS in the elderly and adult age groups was 219 and 193 minutes, respectively, with an overall LOS of 199 minutes. There was a statistical significance (P ≤ .05) between adverse effect and LOS. Patients who experienced a complication remained in the ED for 68 more minutes.ConclusionEtomidate remains as safe and effective an alternative for procedural sedation in the elderly as it is in the general aged population.