Cause of Emergency Department Mortality; a Case-control Study

Area of Science:

• Emergency Medicine
• Clinical Research
• Public Health

Background:

• Emergency departments (EDs) manage diverse critical conditions, with cardiovascular diseases, trauma, and cancers being leading causes of mortality.
• Existing research on ED mortality presents conflicting findings, necessitating further investigation into contributing clinical factors.
• This study addresses the need for clarity on factors influencing patient mortality within the emergency department setting.

Purpose of the Study:

• To identify and evaluate clinical factors associated with increased mortality risk in patients presenting to an emergency department.
• To analyze the impact of specific conditions and patient demographics on emergency department outcomes.
• To provide data for targeted interventions to reduce emergency department mortality.

Main Methods:

• A case-control study involving 2907 patients aged over 18, comparing those who died in the ED (case group) with those discharged or hospitalized (control group).
• Data collection included demographic information, pre-existing conditions, and final diagnoses.
• Statistical analyses employed included Chi-squared tests, multivariate logistic regression, and Pearson's correlation coefficient.

Main Results:

• Cardiovascular diseases (39.2%), severe trauma (18.5%), and cerebrovascular accidents (17.7%) were the primary causes of mortality.
• Key mortality predictors identified by multivariate regression were: cardiovascular complaints (OR=7.3), hypertension history (OR=5.4), severe trauma (OR=4.6), age >60 (OR=3.8), and renal disease diagnosis (OR=3.4).
• Sepsis emerged as an independent risk factor for death in patients over 60 (OR=2.9), and mortality risk significantly increased with the number of risk factors (r²=0.96).

Conclusions:

• Patients with cardiovascular issues, hypertension, severe trauma, advanced age (>60), or renal disease exhibit significantly higher mortality odds in the ED.
• The cumulative effect of multiple risk factors substantially elevates a patient's risk of death, a trend more pronounced in older adults.
• Findings underscore the importance of identifying and managing multiple risk factors to mitigate emergency department mortality.