Dataset Information

Presenting complaints and mortality in a cohort of 22?000 adult emergency patients at a local hospital in Nepal.

ABSTRACT:

Background

There is a need to develop sustainable emergency health care systems in low-resource settings, but data that analyses emergency health care needs in these settings are scarce. We aimed at assessing presenting complaints (PCs) and post-discharge mortality in a large emergency department population in Nepal.

Methods

Characteristics of adult patients who entered the emergency department (ED) in a hospital in Nepal were prospectively recorded in the local emergency registry from September 2013 until December 2016. To assess post-ED mortality, patient households were followed-up by telephone interviews at 90 days.

Results

In 21892 included adults, the major PC categories were injuries (29%), abdominal complaints (23%), and infections (16%). Median age was 40 years and sex distribution was balanced. Among 3793 patients followed at 90 days, 8% had died. For respiratory and cardiovascular PCs, 90-day mortality were 25% and 23%. The highest mortality was in individuals with known chronic lung disease, in this group 32% had died by 90 days of ED discharge, regardless of PC. In women, illiteracy compared to literacy (adjusted odds ratio (aOR)?=?7.0, 95% confidence interval (CI)?=?2.1-23.6) and being both exposed to tobacco-smoking and traditional cooking stove compared to no smoke (aOR?=?2.8, 95% CI?=?1.6-4.9) were associated with mortality. The mortality was much higher among family-initiated discharged patients (17%, aOR?=?5.4, 95% CI?=?3.3-8.9) compared to doctor-initiated discharged (3%).

Conclusions

Our report suggests that nearly one in ten patients seeking emergency health care died within 90 days. This finding is alarming and novel. Post-discharge studies need to be replicated and appropriate follow-up programs in low-resource settings where primary health care is underdeveloped are urgently needed.

SUBMITTER: Giri S

PROVIDER: S-EPMC6708590 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Presenting complaints and mortality in a cohort of 22 000 adult emergency patients at a local hospital in Nepal.

Giri Samita S Rogne Tormod T Uleberg Oddvar O Skovlund Eva E Shrestha Sanu Krishna SK Koju Rajendra R Damås Jan Kristian JK Solligård Erik E Risnes Kari R KR

Journal of global health 20191201 2

<h4>Background</h4>There is a need to develop sustainable emergency health care systems in low-resource settings, but data that analyses emergency health care needs in these settings are scarce. We aimed at assessing presenting complaints (PCs) and post-discharge mortality in a large emergency department population in Nepal.<h4>Methods</h4>Characteristics of adult patients who entered the emergency department (ED) in a hospital in Nepal were prospectively recorded in the local emergency registry ...[more]

PMID: 31489186

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