Death in the Emergency Department: A Retrospective Analysis of Mortality in a Swiss University Hospital.

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State: Public
Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_43E342529830
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Death in the Emergency Department: A Retrospective Analysis of Mortality in a Swiss University Hospital.
Journal
Emergency medicine international
Author(s)
Heymann E.P., Wicky A., Carron P.N., Exadaktylos A.K.
ISSN
2090-2840 (Print)
ISSN-L
2090-2840
Publication state
Published
Issued date
2019
Peer-reviewed
Oui
Volume
2019
Pages
5263521
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Acute treatment in emergency medicine revolves around the management and stabilization of sick patients, followed by a transfer to the relevant medical specialist, be it outpatient or inpatient. However, when patients are too sick to be stabilized, i.e., when the care provided in the Emergency Department (ED) may not be sufficient to enable transfer, death may occur. This aspect of emergency medicine is often overlooked, and very few public data exist regarding who dies in the ED. The following retrospective analysis of the mortality figures of a Swiss university hospital from January 1st 2013 to December 31st 2016 attests to the fact that with an incidence of 2.6/1,000, death does occur in the ED. With a broad range of aetiologies, clinical severity at presentation has a high correlation with mortality, a finding that reinforces the necessity of good triage system. Our analysis goes on to show that however (in)frequent death in the ED may be, there exists a lack of advanced directives in a majority of patients (present in only 14.8% of patients during the time of study), a worrying and often challenging situation for Emergency Medicine (EM) teams faced with premorbid patients. Furthermore, a lack of such directives may hinder access to palliative care, as witnessed in part by the fact that palliative measures were only started in 16.6% of patients during the study. The authors hope this study will serve as a stepping stone to promote further research and discussion into early identification methods for patients at risk of death in the ED, as well as motivate a discussion into the integration of palliative care within the ED and EM training curriculum.
Pubmed
Web of science
Open Access
Yes
Create date
02/10/2019 16:11
Last modification date
15/01/2021 7:09
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