(P2-76) Mortality Pattern in the Emergency Department in Tribhuvan University Teaching Hospital, Kathmandu, Nepal

Abstract

Introduction The emergency department (ED) deals with serious diseases, trauma, and terminal stage cases. The mortality pattern of cases in the ED must be assessed for future planning and development. Objectives The aim of this study is to evaluate the pattern of the mortality cases in ED. Methods Retrospective mortality data were collected and analyzed during April to September 2010 from the Tribhuvan University Teaching Hospital. Results There were 81 mortality records found during the study period. The mortality rate among the ED cases was 36 per 10,000 (0.36%). Sixteen (19.75%) were dead upon arrival to the ED. Among the remaining 65 mortality cases, 30 (46.2%) were male and 35 (53.8%) female. The ages ranged from 1 to 80 years; the mean age for males was 43.8 years and 55.0 years for females. The mean time duration from when the patient was bought to the ED to death was 6.7 hours. The primary causes of mortality were hypovolumic with hemorrhagic shock (10, 15.5%), aspiration pneumonitis (9, 13.8%), cardiopulmonary arrest (8, 12.4%), sepsis and septic shock (7, 10.8%), severe head injury (6, 9.3%), acute exacerbations of chronic obstructive pulmonary disease (6, 9.3%), hemorrhagic cerebrovascular accident (3, 4.7%), hepatic encephalopathy (3, 4.7%), cardiogenic shock (2, 3%), chronic renal failure (2, 3%), dyselectrolytemia (2, 3%), anaphylaxis (1, 1.5%), acute respiratory distress syndrome (1, 1.5%), meningoencepahalitis (1, 1.5%), acute myocardial infarction (1, 1.5%), OP poisoning (1, 1.5%), pulmonary edema (1, 1.5%), and severe pneumonia (1, 1.5%). Conclusions The mortality in the ED is due to the high rate of severe and serious cases that arrive at late stages of disease. It also is accounted with severe trauma cases despite vigorous treatment at the ED. The rate also is increased by "Brought Dead" cases which could be reduced with proper emergency medical services.