Analysis of mortality in the emergency department at a university hospital in Pleven

J Int Med Res. 2017 Oct;45(5):1553-1561. doi: 10.1177/0300060517707901. Epub 2017 Jul 27.

Abstract

Objective To identify the demographic patterns of mortality, the time spent before death in the emergency department (ED), and the causes of fatal outcomes. Methods We performed a 5-year (01/01/2011 to 01/01/2016) retrospective analysis of all non-traumatic deaths in the ED of the UMHAT - Pleven. To extract the necessary information, we used the registers in the ED until the patients' death. Results Among 156,848 patients in the study period, 381 died and the mortality rate was 2.4/100000. The male:female ratio was 1.48:1. The 71-80 years age group was the most affected. The mean (SD) age of patients who died in the ED was 69.9 ± 8.4 years. Most non-traumatic deaths (222 cases) were due to cardiovascular disease. Most patients (70.9%) died within 2.3 h after arrival. The factors contributing to mortality included poverty, transporting the patient to hospital too late, and a lack of developed care centres for terminally ill patients. Conclusion Most patients die within approximately 2 h after arrival at the ED. The main cause of death is acute myocardial infarction. Pulmonary embolism remains unrecognized in most patients (69%). Oncological pathology is among the main causes (7.4%) of mortality.

Keywords: Emergency department; autopsy; death; myocardial infarction; pulmonary embolism.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Autopsy
  • Bulgaria / epidemiology
  • Cause of Death
  • Community-Acquired Infections / epidemiology
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Hospital Mortality*
  • Hospitals, University / statistics & numerical data*
  • Humans
  • Male
  • Myocardial Infarction / mortality
  • Pneumonia / mortality
  • Pulmonary Embolism / mortality