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

Details

Serval ID
serval:BIB_E65181B3F680
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Characteristics and predictors of mortality among frequent users of an Emergency Department in Switzerland.
Journal
European journal of emergency medicine
Author(s)
Griffin J.L., Yersin M., Baggio S., Iglesias K., Velonaki V.S., Moschetti K., Burnand B., Wasserfallen J.B., Vu F., Ansermet C., Hugli O., Daeppen J.B., Bodenmann P.
ISSN
1473-5695 (Electronic)
ISSN-L
0969-9546
Publication state
Published
Issued date
04/2018
Peer-reviewed
Oui
Volume
25
Number
2
Pages
140-146
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
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.
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.
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.
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.

Pubmed
Web of science
Create date
25/10/2016 17:28
Last modification date
20/08/2019 16:09
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