Emergency Department Deaths in a Nigerian University Hospital: Deaths Too Many

Area of Science:

• Emergency Medicine
• Public Health
• Healthcare Management

Background:

• The University College Hospital (UCH) emergency department (ED) experiences significant patient volume and mortality.
• Understanding demographic patterns and causes of death in the ED is crucial for improving patient outcomes and healthcare quality.

Purpose of the Study:

• To analyze the demographic patterns and distribution of deaths within the UCH emergency department.
• To identify gaps in the standard of care for acute care patients.
• To provide evidence for interventions and enhance research in emergency medicine.

Main Methods:

• Retrospective study of all deaths in the UCH ED from January 1 to December 31, 2011.
• Data extracted from the ED's electronic register following institutional ethics approval.

Main Results:

• A total of 647 deaths occurred out of 10,728 emergency attendances, yielding a 6.0% mortality rate.
• The majority of deaths (62%) were male, with the highest proportional mortality in the 60-69 age group.
• Most deaths (75.4%) occurred within 24 hours of arrival, with 50% during night shifts; only 5.6% had autopsies.

Conclusions:

• High in-hospital mortality within 24 hours of ED presentation necessitates urgent attention.
• Recommendations include enhancing pre-hospital care, optimizing emergency transport systems, and implementing new guidelines and protocols.
• Regular audits are essential for continuous quality improvement in acute care services.