Abebe Fikadu, Habtamu Asaminew, Workina Abdata
Midwifery School, Jimma University, Jimma, Ethiopia.
Nursing School, Jimma University, Jimma, Ethiopia.
Open Access Emerg Med. 2023 Sep 7;15:293-302. doi: 10.2147/OAEM.S420660. eCollection 2023.
Mortality in the emergency department is still high in developing countries with resources scarce. Most of emergency department mortality occurred within the first three days; the majority of these deaths are avoidable with proper intervention. Therefore, the purpose of this study was to assess the mortality risks and therapeutic benefits of early and late death.
Case-control study approach with 87 cases and 174 controls (case to control ratio of 1:2) was used on 261 study participants. Data were extracted from the patient charts using a pretested extraction tool. Then, checked data were entered into Epi-data manager 4.6 versions and analyzed using SPSS 25 versions. Binary logistic regression was used to construct bivariate and multivariable analyses following the descriptive analysis. Finally, a predictor variable in the multivariate logistic regression was deemed to have a significant association if its -value was less than 0.05 at a 95% confidence level.
Patients who were triaged into the red zone had a 2.3-fold greater risk of dying early than those who were placed in another triage category [(AOR=2.3; 95% CI: 1.10, 5.55) =0.001]. Besides, having cardiovascular disease (AOR=4.79; 95% CI: 1.73, 13.27), age ≥65 years [(AOR=3.2; 95% CI: 1.74, 7.23) =0.003)], having rural residency (AOR=6.57; 95% CI: 1.39, 31.13), and having been diagnosed with respiratory failure [(AOR=3.2; 95% CI: 1.04, 7.69), =0.013)] were associated with early mortality.
The common causes of early mortality were respiratory failure, cardiovascular disease, and road traffic accident. Being aged, having rural residence, being triaged into red zone, and diagnosed for respiratory failure and cardiac failure increase early mortality compared with late death.
在资源匮乏的发展中国家，急诊科的死亡率仍然很高。大多数急诊科死亡发生在头三天内；通过适当干预，这些死亡中的大多数是可以避免的。因此，本研究的目的是评估早期和晚期死亡的死亡风险及治疗益处。
对261名研究参与者采用病例对照研究方法，有87例病例和174名对照（病例与对照比例为1:2）。使用预先测试的提取工具从患者病历中提取数据。然后，将检查后的数据输入Epi - data管理器4.6版本，并使用SPSS 25版本进行分析。在描述性分析之后，使用二元逻辑回归进行双变量和多变量分析。最后，在95%置信水平下，如果多变量逻辑回归中的预测变量的P值小于0.05，则认为其具有显著关联。
被分诊到红色区域的患者早期死亡风险比被分到其他分诊类别的患者高2.3倍[（调整后比值比=2.3；95%置信区间：1.10，5.55），P = 0.001]。此外，患有心血管疾病（调整后比值比=4.79；95%置信区间：1.73，13.27）、年龄≥65岁[（调整后比值比=3.2；95%置信区间：1.74，7.23），P = 0.003]、居住在农村（调整后比值比=6.57；95%置信区间：1.39，31.13）以及被诊断为呼吸衰竭[（调整后比值比=3.2；95%置信区间：1.04，7.69），P = 0.013]与早期死亡率相关。
早期死亡的常见原因是呼吸衰竭、心血管疾病和道路交通事故。与晚期死亡相比，年龄较大、居住在农村、被分诊到红色区域以及被诊断为呼吸衰竭和心力衰竭会增加早期死亡率。
