Predictors of long-term mortality from a 23-year database of emergency medical admissions

There is much focus on the management of the acute emergency medical admission, however, long term outcome data following discharge are sparse.

We report all the outcome of emergency admissions to an AMAU (Acute Medical Admission Unit) over 23 years (2002-2024). Data was matched to the Irish National Death Register to capture post-discharge mortality. Predictors of long-term mortality were determined from logistic and Cox regression.

The 2002-2024 cohort consisted of 186,004 episodes in 95,192 patients, with 14,092 in-hospital deaths within 30-days. Post discharge, to April 2025, there were an additional 17,808 deaths - 31,900 in total (33.5%) of the admitted cohort. Predictors of long-term mortality were age OR 2.03 (95%CI 1.92, 2.15), AISS OR 1.44 (95%CI 1.40, 1.48), Charlson Comorbidity Score OR 1.28 (95%CI 1.24, 1.32) and a Neurology MDC primary diagnosis 1.11 (95%CI 1.02, 1.19). A high Comorbidity Score, reduced survival half-life to ~ 50. Performance of a blood culture, during the acute admission, predicted worse long-term outcomes, irrespective of its result.

The emergency medical admission is a sentinal event, long-term survival appears better than that projected in the literature .