Emergency department deaths despite active management: experience from a tertiary care centre in a low-income country
Objective: To determine the frequency and causes of ED deaths despite active management, in a tertiary care centre of a low-income country.
Methods: We conducted a retrospective chart review over a 2 year period (January 2001–December 2002) for all patients who died despite active management in an ED in Karachi, Pakistan.
Results: Of the 78 418 patient visits, 601 patients (0.7%) were pronounced dead. Of these, 577 patients had complete records. Seventy per cent of these were dead-on-arrival, 1% had do-not-resuscitate orders and 29% (n = 166; 95% confidence interval [CI] 25–32%) died despite active management. Initial vital signs were found to be abnormal in almost all cases (98%). The leading causes of death were sepsis (23%; 95% CI 19–26%), myocardial infarction (19.7%; 95% CI 16–22%), cerebrovascular accident (10.7%; 95% CI 8–13%) and pneumonia (8.2%; 95% CI 6–10%) among adults and sepsis (36.4%; 95% CI 32–40%), myocarditis (15.9%; 95% CI 13–18%) and pneumonia (9.1%; 95% CI 6–11%) among children.
Conclusion: Sepsis is the leading cause of death in patients of all age groups in the ED of this hospital.
Emergency Medicine Australasia
Khan, N. U.,
Razzak, J. A.,
Alam, S. M.,
(2007). Emergency department deaths despite active management: experience from a tertiary care centre in a low-income country. Emergency Medicine Australasia, 19(3), 213-217.
Available at: http://ecommons.aku.edu/pakistan_fhs_mc_fam_med/71