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KMID : 1130220190230030133
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Annals of Geriatric Medicine and Research
2019 Volume.23 No. 3 p.133 ~ p.140
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Risk Factors and Causes of Short-Term Mortality after Emergency Department Discharge in Older Patients: Using Nationwide Health Insurance Claims Data
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Na Seung-Gu
Cho Yong-Il
Lim Tae-Ho
Kang Hyung-Goo
Oh Jae-Hoon
Ko Byuk-Sung
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Abstract
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Background: The purpose of this study was to identify the risk factors and causes of short-term mortality after emergency department (ED) discharge in older patients.
Methods: This population-based cohort study used nationwide health insurance claims data in Korea from 2008 to 2014. The causes of death and diagnoses of patients who died within 1 week after discharge from EDs (1-week ED death) were obtained. The risk factors for 1-week ED death were calculated using Cox proportional hazard regression analyses.
Results: The rate of 1-week ED death was 0.5% among 133,251 individuals aged ≥65 years discharged from EDs. In multivariate analysis, the top five ED discharge diagnoses associated with an increased risk of 1-week ED death were hypotension and vascular disease (adjusted hazard ratio [aHR]=5.11; 95% confidence interval [CI], 3.03?8.63), neoplasm (aHR=4.89; 95% CI, 3.77?6.35), coronary artery disease (aHR=3.83; 95% CI, 2.73?5.39), dyspnea (aHR=3.41; 95% CI, 2.48?4.68), and respiratory disease (aHR=2.25; 95% CI, 1.73?2.92). The most common causes of 1-week ED death were neoplasm (14.8%), senility (13.8%), and cerebrovascular disease (11.7%).
Conclusion: Neoplasm, coronary artery disease, and respiratory disease were the discharge diagnoses associated with an increased risk of short-term mortality after ED discharge. Neoplasm was the leading cause of short-term mortality after ED discharge in older patients.
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KEYWORD
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Aged, Mortality, Emergency departments, Risk factors
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