Death after discharge from the emergency department

Area of Science:

• Emergency Medicine
• Public Health
• Forensic Pathology

Background:

• Patients discharged from emergency departments (EDs) may experience unexpected deaths.
• Understanding the rate and causes of these deaths is crucial for improving patient safety and ED protocols.

Purpose of the Study:

• To determine the incidence and causes of death in patients discharged from the ED.
• To investigate the relationship between the cause of death and the initial ED visit.

Main Methods:

• Retrospective review of medical examiner cases for patients discharged from an ED within 8 days of death.
• Analysis of 2,665 medical examiner cases from a single urban county ED system over a one-year period.

Main Results:

• A death rate of 13 per 100,000 discharged patients was observed.
• Of the 42 cases meeting criteria, 21% (9 cases) were unexpected and directly related to the ED visit.
• Ruptured aortic aneurysm was the most frequent cause of unexpected, directly related death (3 of 9 cases).

Conclusions:

• Death following emergency department discharge is an infrequent event.
• Ruptured aortic aneurysm represents the primary cause of unexpected mortality directly linked to the ED encounter.