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Collapse in an accident and emergency department
A J McLaren1, J Lear, R G Daniels
1Harlow Wood Orthopaedic Hospital, Mansfield, Nottingham, UK.
Journal of the Royal Society of Medicine
|March 1, 1994
Summary
Collapse presentations to accident and emergency (A & E) departments are common, affecting 2.9% of attendances. This patient group experiences high admission and mortality rates, particularly the elderly, necessitating careful screening for underlying conditions.
Area of Science:
- Emergency Medicine
- Geriatric Medicine
- Internal Medicine
Background:
- Collapse is a frequent reason for patients to visit accident and emergency (A & E) departments.
- The diverse range of potential causes for collapse presents diagnostic challenges.
Purpose of the Study:
- To analyze the incidence, causes, and outcomes of collapse presentations in an A & E department.
- To identify patient groups at higher risk and inform management strategies.
Main Methods:
- Retrospective study of 4180 new attendances at a district general hospital A & E department.
- Data collected on patient demographics, diagnosis, admission rates, and mortality.
Main Results:
- Collapse accounted for 2.9% of A & E attendances.
- The study revealed a wide spectrum of diseases implicated in collapse.
- This patient group had a high admission rate (47.8%) and a high mortality rate (31.3%).
- Mortality was predominantly observed in elderly patients.
Conclusions:
- Elderly patients presenting with collapse require careful screening for underlying pathology or admission for observation.
- The heterogeneity of causes for collapse prevents the establishment of a standardized management protocol.
- Further research into specific high-risk subgroups may be warranted.