Scientific article
OA Policy
English

Characteristics and predictors of mortality among frequent users of an Emergency Department in Switzerland

Published inEuropean Journal of Emergency Medicine, vol. 25, no. 2, p. 140-146
Publication date2018
Abstract

Objectives: Frequent Emergency Department (ED) users have an elevated mortality, yet little is known about risk factors. Our aim was to characterize deceased frequent ED users and determine predictors of mortality.

Methods: This is a post-hoc analysis of all-cause mortality among frequent ED users participating in a randomized clinical trial on case management at the Lausanne University Hospital (Switzerland). We enrolled 250 frequent ED users (5+ visits/past year) in a 12-month randomized clinical trial; those with an estimated survival of fewer than 18 months were excluded. The primary outcome was 12-month all-cause mortality. We performed descriptive statistics to compare the baseline characteristics of living and deceased participants, and examined predictors of all-cause mortality using logistic regressions, including age adjustment.

Results: Twenty of the 250 (8%) frequent users died during the 12-month follow-up. Seven (35%) deaths were because of cardiac causes and six (30%) were because of cancer. The median age at death was 71 years. Deceased participants were older and more likely to report any somatic determinant, chronic illness, and medical comorbidity. Age (odds ratio 1.07, 95% confidence interval 1.04-1.11) and medical comorbidity (odds ratio 4.76, 95% confidence interval 1.86-12.15) were statistically significant predictors of mortality.

Conclusion: Despite excluding those with an estimated survival of fewer than 18 months, 8% of frequent ED users died during the study. Age and medical comorbidity were significant predictors of mortality. Interventions, such as case management, should target older frequent ED users and those with multiple medical conditions, and future research should explore their potential impact on mortality.

Keywords
  • Aged
  • Aged, 80 and over
  • Emergency Service, Hospital / statistics & numerical data
  • Female
  • Humans
  • Male
  • Medical Overuse / statistics & numerical data
  • Middle Aged
  • Mortality
  • Patient Acceptance of Health Care / statistics & numerical data
  • Patient Admission / statistics & numerical data
  • Severity of Illness Index
  • Switzerland
  • Vulnerable Populations / statistics & numerical data
Affiliation entities Not a UNIGE publication
Citation (ISO format)
GRIFFIN, Judith L. et al. Characteristics and predictors of mortality among frequent users of an Emergency Department in Switzerland. In: European Journal of Emergency Medicine, 2018, vol. 25, n° 2, p. 140–146. doi: 10.1097/MEJ.0000000000000425
Main files (2)
Article (Published version)
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Article (Accepted version)
accessLevelPublic
Identifiers
ISSN of the journal0969-9546
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Technical informations

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