Patients who Die Within Emergency Department: A Descriptive Study

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 A total of 355 patients who died within the ED were included in study. Their mean age was 57.8 ± 20.5 years (range: 0–114 years), and 53.8% were male. The most common primary complaint was chest pain. Of the patients, most (65.1%) died of cardiac diseases, followed by diseases of the respiratory system (13.5%), and cerebrovascular diseases (4.5%). The most frequent cause of ED deaths was acute myocardial infarction (MI) (n = 202, 56.6%). The highest mortality rate occurred in patients aged at least 50 years (n = 314, 88.5%). In the three distinct groups of patients aged at least 50 years, the highest mortality rate was observed in those aged 75 years and over (n = 156, 44%). Deaths caused by cardiac diseases were the most prevalent in the patients aged 71-80 years, while deaths caused by diseases of the respiratory and cerebrovascular systems were the most prevalent in the patients aged 81-114 years. A total of 58.8% of the patients had at least one chronic disease in their medical history. Recording of the major complaint was incomplete in 70.4% of patients. Conclusions: The highest mortality rate occurred in patients aged at least 50 years, and reached a maximum in those aged 75 years and over. The majority of the deaths within the ED were due to cardiovascular system diseases, and the most common diagnosis was acute MI. Deaths in the ED can be very traumatic for physicians, our study reinforces that the most common causes of death are in line with national statistics.

The characteristics of patients who die are an outcome that can be used to improve knowledge of a service. Deaths in the emergency department (ED) have unique characteristics, and a description of deaths in the ED could be used to assess trends within individual institutions. With an increasing number of patient admissions, the ED can become crowded and chaotic, and deaths are stressful situations that commonly occur in the routine work of an emergency physician. The high frequency of ED deaths necessitates that ED physicians prepare themselves for the issues surrounding death, and mortality statistics are important in the description of an ED [2]. Published studies describing patients who have died within the ED are scarce. This, and the fact that the ED patient databases cannot be fully developed, constitutes a great obstacle in determining ED requirements, and in revealing patient profiles. The present study aimed to investigate the demographic and etiologic characteristics of the patients who died in one particular ED.

This retrospective, cross-sectional study was conducted in patients who died in the ED of Adiyaman University Training and Research Hospital between 01 January 2013 and 31 December 2015. It is a single center serving Adiyaman city, which is located in the west of the Southeastern Anatolia region of Turkey. There is no admission for pediatric patients in the Adiyaman University Training and Research Hospital ED, except for those requiring surgery. The study was performed in compliance with the World Medical Association Declaration of Helsinki on Ethical Principles for Medical Research Involving Human Subjects and was approved by the Medical Ethics Committee (number: 1-11/2016). It was verified according to the checklist for observational studies in Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) and registered to Clinicaltrials (clinicaltrials.gov ID: NCT03138707).