An Investigation of Risk Factors Affecting Short Term Mortality of Patients Referring to the Hospital Emergency Department (original) (raw)
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An Epidemiologic Study on Emergency Department Mortality
2018
Introduction: Epidemiologic evaluation generally starts with recording the raw data regarding mortality, and healthcare managers should have a national plan executed for this purpose. Objective: The present study was planned and performed with the aim of epidemiologically evaluating mortality cases among patients admitted to the emergency department (ED) of a major hospital in Tehran, Iran in order to plan and provide proper equipment for decreasing the mortality of patients. Result: Over the mentioned period of time, in total, the data of 8420 admissions to the ED were recorded. Out of these patients, 76 (0.9%) had died, the mean age of whom was 67.66 ± 21.40 years. Based on these findings, among patients who had presented to the ED, 42.1% died due to the complications of heart attack and 13.2% died from complications caused by cancer. Conclusion: Based on the findings of the present study, cardiovascular complications were the most leading cause of mortality in the studied ED and complications resulting from malignancy were in the second place. Trauma and accidents leading to intracranial hemorrhage were in the next places.
The Open Public Health Journal, 2020
Emergency Departments (ED) are highly important in hospital settings because they offer 24-hour professional assistance to patients in need of healthcare. However, ED overcrowding has started to become a global healthcare crisis, such that the patient capacity of EDs is no longer sufficient to meet patient demand. Thus, this study aimed to determine the relationship between ED overcrowding and the mortality rate of patients to draw the attention of decision makers in Saudi Arabia toward this issue, with the hope of ultimately attaining a solution to this problem. Using patients’ electronic health records that were stored in the Quadra Med system in 2018, we calculated the occupancy rates of the ED of a target teaching hospital at different quarters and associated those figures with the mortality rates for the same quarters. Our results showed that there was no significant association between mortality rate and crowding status in the ED. Nonetheless, we recommend increasing public aw...
Open Access Emergency Medicine : OAEM, 2021
Background Emergency department (ED) crowding has been described as the most serious problem that endangers the reliability of healthcare system worldwide. The aim of this study was to explore the possible relationship of ED crowding status and length of stay in patient received care. In addition, association between LOS and other variables in relation to crowding status has been explored. Methods This is a retrospective cohort analysis study done by using dataset abstracted from Quadra Med Information System of patients visited emergency department of a tertiary university hospital at Eastern Province of Saudi Arabia during the period of January 1st, 2018 to December 30th, 2018. ED occupancy rates were used to define crowding status (as crowding and overcrowding), while the percentage of patient who spent in ED more than 6 hours was used to define the length of stay in ED. Results There were 53,309 crowded and 57,290 overcrowded presentations in ED. The median length ± interquartil...
2019
Objective: To determine factors associated with overcrowding in the Emergency Department (ED) and make suggestions in the light of current data. Material and Methods: In a 3-year period, the number of patients admitted to our ED, number of forensic examination cases, number of patients who died, waiting times and Length of Stay (LOS) in the ED, consultation arrival times, length of laboratory result times, number of patients followed up in ED observation room and hospitalized to a ward were recorded. Findings were compared according to years. Results: Number of patients admitted to the ED did not significantly differ among years. LOS in the ED and the number of patients followed-up in the ED observation room increased significantly when compared according to years. Number of consultations also tended to increase. Even though the number of patients admitted to the red zone increases, when compared to 2016, mortality rate was significantly lower in 2017 and 2018. Conclusion: Rapid tra...
Iranian Red Crescent Medical Journal, 2017
Background: The reason behind patients' overcrowding in emergency departments (ED) may be due to several factors such as great number of referring patients or inaccessibility of facilities or hospital beds. Objectives: The present study aimed at evaluating the overcrowding of ED in Tabriz Imam Reza hospital in 2015 using 2 scales: National Emergency Overcrowding Scale (NEDOCS), and Emergency Department Work Index (EDWIN). Methods: This was a cross-sectional descriptive study conducted in the ED of Imam Reza hospital affiliated to Tabriz University of Medical Sciences, Iran, in a one-year period (Jan-Dec 2015). Convenience sampling method was used for data collection. During the study, the researchers randomly selected 10 days out of every month and started to collect index variables 4 times a day at 6 AM, 12 noon, 6 PM, and 12 midnight. In total, 488 samples were gathered and both NEDOCS and EDWIN were implemented for each sample. Then, the frequency of overcrowding in the emergency department was reported based on the obtained results. Results: Based on NEDOCS, ED was extremely busy, but not overcrowded in 51 cases (10.5%), it was overcrowded in 298 (61.1%) cases, severely overcrowded in 138 cases (28.3%), and it was busy only in one case (0.2%). However, based on the EDWIN scale, the ED was active but manageable in 91 cases (18.6%), very busy in 36 cases (7.4%), and extremely busy in the remaining 361 cases (74%). Conclusions: EDWIN scale depicted August, July, December, June, and April to be, respectively, the most overcrowded months. This finding revealed EDWIN scale to perform better when trying to have an overall assessment of ED during the whole year, which helps us have clear-cut results for analysis and policy making in managing EDs.
Cause of Emergency Department Mortality; a Case-control Study
SBMU publishing, 2014
Introduction: Based on previous studies, cardiovascular diseases, traffic accidents, traumas and cancers are the most important etiology of mortalities in emergency departments (ED). However, contradictory findings have been reported in relation to mortality in emergency departments. Therefore, the present study was undertaken to evaluate the role of clinical factors in mortality among patients referring to an emergency department in a third-level hospital in Tehran, Iran. Methods: In the present case-control study, all the patients over 18 years of age were evaluated, referring to the ED of Imam Hossein Hospital, Tehran, Iran, from the beginning of 2009 to the end of 2010. The patients died in the ED were placed in the case group and those discharged or hospitalized in other hospital wards in the control group. Demographic data, background diseases, and the final diagnoses were recorded. Chi-squared test, multivariate logistic regression, and Pearson’s correlation coefficient were used to evaluate the relationship between the variables mentioned above and patient mortality. Results: A total of 2907 patients (969 (59.9% male) in the case and 1938 (62.2% male) in the control groups) were evaluated. Cardiovascular diseases (39.2%), severe traumas (18.5%), and cerebrovascular accidents (17.7%) were the most frequent etiology of patient mortality in ED. Multivariate regression analysis showed that presentation with cardiovascular complaints (OR=7.3; 95% CI: 3.5-16.1; p<0.001), a history of hypertension (OR=5.4; 95% CI: 1.2-12.3; p<0.001), severe trauma (OR=4.6; 95% CI: 2.0-13.2; p<0.001), age over 60 (OR=3.8; 95% CI: 1.8-7.8; p<0.01) and a final diagnosis of renal disease (OR=3.4; 95% CI: 2.1-6.4; p<0.001) were factors that increased the odds of mortality in patients referring to the ED. Multivariate regression analysis in patients over 60 years showed that sepsis was an independent factor increasing the risk of death (OR=2.9; 95% CI: 1.3-5.9; p=0.009). A patient’s risk of death increases with an increase in the number of risk factors in that patient (r2=0.96; p=0.02). Conclusion: It appears the odds of mortality in patients referring to ED with cardiovascular complaints, a history of hypertensive, severe trauma, age over 60 and a final diagnosis of renal disease are higher versus other patients. In addition, the patients’ odds of death increase with an increase in the number of risk factors. Such an increase is more noticeable at age over 60.
Background: As we live in a world of evidence-based medicine and public health, the stated goal of achieving a remarkable acute care system necessitates regressive managerial oversight and intervention based on science. The purpose of this study was to examine the pattern and determinants of all-cause mortality at St. Paul Hospital. Emergency Department at Millennium Medical College Methods: Data were gathered retrospectively from patient records from January 1, 2020 through June 30, 2022. SPSS Version 25 was used to analyze the data. The Chi-square test, as well as binary and multiple logistic regression analysis, were used to determine the relationship between variables of interest and early emergency mortality. To determine the significant factors, P-values of 0.05 and AOR with % CI were applied. Result: In 2 and half years’, 22,982, clients visited the ED and death within 24 hours 173 (44%) and 158 (42%) died after 24 hours of ED stay. Sepsis or septic shock (16.8%), respiratory...
Abstract Objective: Standardization of hospital emergency units is a major goal in developed countries to decrease the duration of patients stay in these units. The present study was undertaken to evaluate the prevalence of long-term staying in an emergency ward. Methods: In the present 2-month cross-sectional study, patients referring to the emergency ward of Imam Hossein hospital were assessed. The patients’ demographic data, including age, the presenting symptoms and signs, reasons for delays, and the final outcome in relation to the location of hospitalization and discharge information were recorded. Data were reported as frequencies and percentages. The results were reported as means and standard deviations using SPSS version 20. Results: Of 10087 patients admitted into the emergency ward during a 2-month period, 75 patients (0.7%) needed to stay and wait for more than 24 hours. The mean ± standard deviation of the patients’ ages was 62.5 ± 20.2 years, with 60% of the patients being over 60 years of age. The most common reason for overcrowding in the emergency ward was a lack of empty beds, with the need for ICU beds as the most important reason for bed deficiency in 59% of the cases. Nervous system problems were the most common reasons for referring to the emergency unit (41%) in patients under study. Finally, 81% of the patients were hospitalized, 10% died, 7% were discharged based on personal request and 1.3% were transferred to another hospital. Conclusion: The prevalence of patients staying and waiting in the emergency ward for more than 24 hours was 0.7%. Lack of empty ICU beds was the most important reason for such delays; however, paraclinical problems had no role in these delays which were associated with the death of 10% of patients. Keywords: Emergency, Staying, Long, Overcrowding
Increase in patient mortality at 10 days associated with emergency department overcrowding
The Medical journal of Australia, 2006
To quantify any relationship between emergency department (ED) overcrowding and 10-day patient mortality. Retrospective stratified cohort analysis of three 48-week periods in a tertiary mixed ED in 2002-2004. Mean "occupancy" (a measure of overcrowding based on number of patients receiving treatment) was calculated for 8-hour shifts and for 12-week periods. The shifts of each type in the highest quartile of occupancy were classified as overcrowded. All presentations of patients (except those arriving by interstate ambulance) during "overcrowded" (OC) shifts and during an equivalent number of "not overcrowded" (NOC) shifts (same shift, weekday and period). In-hospital death of a patient recorded within 10 days of the most recent ED presentation. There were 34 377 OC and 32 231 NOC presentations (736 shifts each); the presenting patients were well matched for age and sex. Mean occupancy was 21.6 on OC shifts and 16.4 on NOC shifts. There were 144 deaths i...
Emergency Department Overcrowding in Turkey: Reasons, Facts and Solutions
Journal of Nepal Medical Association
Introduction: The purpose of this study was to determine the factors affecting the long waiting times of the patients in a university hospital. Methods: This study included 3000 of the adults above 18 years and pediatric trauma patients under 18 years who applied to emergency department between February 2009 and April 2009. The examination period of the physician, length of stay, length of hospitalization, waiting times for hospitalization and follow up times in the emergency department were recorded. Moreover, the patients were divided into four groups according to the reasons for waiting. Results: In our study, the time period between 4 pm-12 pm was determined as the busiest time for the applications. Average length of stay in the emergency department for 3000 patients was 146.7±160.2 minutes. The length of stay for the patients consulted was longer than the length of stay for the ones who were not consulted. Because of the fact that our hospital did not have appropriate bed capac...