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Prevalence of organ failure and mortality among patients in the emergency department: a population-based cohort study.


ABSTRACT:

Objectives

The aim was to describe population-based incidence and emergency department-based prevalence and 1-year all-cause mortality of patients with new organ failure present at arrival.

Design

This was a population-based cohort study of all citizens in four municipalities (population of 230?000 adults).

Setting

Emergency department at Odense University Hospital, Denmark.

Participants

We included all adult patients who arrived from 1 April 2012 to 31 March 2015.

Primary and secondary outcome measures

Organ failure was defined as a modified Sequential Organ Failure Assessment score?2 within six possible organ systems: cerebral, circulatory, renal, respiratory, hepatic and coagulation.The primary outcome was prevalence of organ failure, and secondary outcomes were 0-7?days, 8-30?days and 31-365?days all-cause mortality.

Results

We identified in total 175?278 contacts, of which 70?399 contacts were further evaluated for organ failure. Fifty-two per cent of these were women, median age 62 (IQR 42-77) years. The incidence of new organ failure was 1342/100 000 person-years, corresponding to 5.2% of all emergency department contacts.The 0-7-day, 8-30-day and 31-365-day mortality was 11.0% (95% CI: 10.2% to 11.8%), 5.6% (95% CI: 5.1% to 6.2%) and 13.2% (95% CI: 12.3% to 14.1%), respectively, if the patient had one or more new organ failures at first contact in the observation period, compared with 1.4% (95% CI: 1.3% to 1.6%), 1.2% (95% CI: 1.1% to 1.3%) and 5.2% (95% CI: 5.0% to 5.4%) for patients without. Seven-day mortality ranged from hepatic failure, 6.5% (95% CI: 4.9% to 8.6%), to cerebral failure, 33.8% (95% CI: 31.0% to 36.8%), the 8-30-day mortality ranged from cerebral failure, 3.9% (95% CI: 2.8% to 5.3%), to hepatic failure, 8.6% (95% CI: 6.6% to 10.8%) and 31-365-day mortality ranged from cerebral failure, 9.3% (95% CI: 7.6% to 11.2%), to renal failure, 18.2% (95% CI: 15.5% to 21.1%).

Conclusions

The study revealed an incidence of new organ failure at 1342/100 000 person-years and a prevalence of 5.2% of all emergency department contacts. One-year all-cause mortality was 29.8% among organ failure patients.

SUBMITTER: Pedersen PB 

PROVIDER: S-EPMC6830583 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Publications

Prevalence of organ failure and mortality among patients in the emergency department: a population-based cohort study.

Pedersen Peter Bank PB   Henriksen Daniel Pilsgaard DP   Brabrand Mikkel M   Lassen Annmarie Touborg AT  

BMJ open 20191030 10


<h4>Objectives</h4>The aim was to describe population-based incidence and emergency department-based prevalence and 1-year all-cause mortality of patients with new organ failure present at arrival.<h4>Design</h4>This was a population-based cohort study of all citizens in four municipalities (population of 230 000 adults).<h4>Setting</h4>Emergency department at Odense University Hospital, Denmark.<h4>Participants</h4>We included all adult patients who arrived from 1 April 2012 to 31 March 2015.<h  ...[more]

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