Objective Given that there are no studies on diseases that occur by waiting for hospitalization, we aimed to evaluate the main causes of death in the emergency room (ER) and their relationship with overcrowding.
Methods Patients who died in the ER in the past 2 years (pediatrics and trauma victims excluded) were divided into two groups: patients who died within 6 hours of arrival (emergency department [ED] group) and patients who died later (LD group). We compared the causes of death, total vital signs, diagnostic tests performed, and therapy between the groups. We assessed for possible correlation between the number of monthly deaths per group and four variables of overcrowding: number of patients treated per month, waiting time before medical visit (W-Time), mean intervention time (I-Time), and number of patients admitted to the ward per month (NPA).
Results During the two years, 175 patients had died in our ER (52% in ED group and 48% in LD group). The total time spent in the ER was, respectively, 2.9±0.2 hours for ED group and 17.9± 1.5 hours for LD group. The more frequent cause of death was cardiovascular syndrome (30%) in ED group and sepsis (27%) and acute respiratory failure (27%) in LD group. Positive correlations between number of monthly deaths and W-Time (R2 0.51, P<0.001), I-Time (R2 0.73, P< 0.0001), and NPA (R2 0.37, P<0.01) were found only in LD group.
Conclusion Patients with sepsis and acute respiratory failure die after a long stay in the ER, and the risk increases with overcrowding. A fast-track pathway should be considered for hospital admission of critical patients.
Citations
Citations to this article as recorded by
Non-Surgical Causes of Death in the Emergency Department: A Five-Year Monocentric Clinicopathological Study Adrian-Iosif Moldoveanu, Diana Maria Orzata, Gabriel Veniamin Cozma, Radu Gheorghe Dan, Ovidiu Alexandru Mederle, Flavia Zara Medicina.2026; 62(2): 293. CrossRef
Using space technology approach to improve quality in emergency departments in India: a quality improvement program Saravana Kumar, Gunaseelan Vikneswaran, Jitendra Suryavamshi, Srinath Kumar, Manzoor Shaik, G K Reshma, M R Suresh, Alben Sigamani, V C Shanmuganandan, Alexander Thomas, A N Venkatesh, Imron Subhan, M Rajadurai, Sateesh Kumar Kailasam, B Nivetha, K U Sham International Journal for Quality In Health Care.2026;[Epub] CrossRef
Neutrophil to lymphocyte ratio (NLR) and short-term mortality risk in elderly acute medical patients admitted to a University Hospital Emergency Department Gioacchino Galardo, Luca Crisanti, Andrea Gentile, Marco Cornacchia, Francesca Iatomasi, Iacopo Egiddi, Emanuele Puscio, Danilo Menichelli, Francesco Pugliese, Daniele Pastori Internal and Emergency Medicine.2025; 20(2): 553. CrossRef
Diagnostic performance of S100B assay for intracranial hemorrhage detection in patients with mild traumatic brain injury under antiplatelet or anticoagulant therapy Paul-André Poislane, Mathilde Papin, Damien Masson, Nicolas Goffinet, Arthur David, Quentin Le Bastard, Hugo De Carvalho Scientific Reports.2025;[Epub] CrossRef
Invited Editorial: Waiting Room Care is Not the Solution to Emergency Department Boarding Andrew J. Bouland, Juan A. March JACEP Open.2025; 6(3): 100161. CrossRef
Shortening emergency department length of stay: Fast track, short-stay unit and acute medical unit Bei Huang Exploratory Research in Clinical and Social Pharmacy.2025; 19: 100626. CrossRef
Multidisciplinary Staff Experiences of Providing End-of-Life Care in an Acute Hospital Setting Mia Werrett, Joanna McIlveen, Mim Fox Hospitals.2025; 2(3): 15. CrossRef
OrthoMortPred: Predicting one-year mortality following orthopedic hospitalization Filipe Ricardo Carvalho, Paulo Jorge Gavaia, António Brito Camacho International Journal of Medical Informatics.2024; 192: 105657. CrossRef
Comment on: "30 days mortality prognostic value of POCT bio-adrenomedullin and proenkephalin in patients with sepsis in the emergency department" Gabriele VALLI, Francesca DE MARCO, Silvia CASALBONI, Maria P. RUGGIERI Italian Journal of Emergency Medicine.2023;[Epub] CrossRef
Can Acute Care Biomarkers Change Patient’s Management in Sepsis? Salvatore Di Somma, Luca Crisanti Eurasian Journal of Emergency Medicine.2022; 21(2): 79. CrossRef
Characteristics and timing of mortality in children dying in pediatric intensive care: a 5-year experience Edin Botan, Emrah Gün, Emine Kübra Şden, Cansu Yöndem, Anar Gurbanov, Burak Balaban, Fevzi Kahveci, Hasan Özen, Hacer Uçmak, Ali Genco Gençay, Tanil Kendirli Acute and Critical Care.2022; 37(4): 644. CrossRef
30 Days Mortality Prognostic Value of POCT Bio-Adrenomedullin and Proenkephalin in Patients with Sepsis in the Emergency Department Silvia Casalboni, Gabriele Valli, Ferdinando Terlizzi, Marina Mastracchi, Giacomo Fidelio, Francesca De Marco, Caterina Bernardi, Anastasia Chieruzzi, Alessia Curcio, Francesco De Cicco, Nicola Colella, Ilaria Dafne Papasidero, Emanuele Tartarone, Maria P Medicina.2022; 58(12): 1786. CrossRef
Impact of the 24-hour time target policy for emergency departments in South Korea: a mixed method study in a single medical center Sookyung Park, Hansol Chang, Weon Jung, Se Uk Lee, Sung Yeon Hwang, Hee Yoon, Won Chul Cha, Tae Gun Shin, Min Seob Sim, Ik Joon Jo, Taerim Kim BMC Health Services Research.2022;[Epub] CrossRef
Utility of Measuring Circulating Bio-Adrenomedullin and Proenkephalin for 30-Day Mortality Risk Prediction in Patients with COVID-19 and Non-COVID-19 Interstitial Pneumonia in the Emergency Department Ilaria Dafne Papasidero, Gabriele Valli, Dario Marin, Alberto Del Sasso, Antonio De Magistris, Elisa Cennamo, Silvia Casalboni, Francesca De Marco, Roberta Rocchi, Brice Ndogmo Beumo, Valeria Cusani, Mariarosa Gaudio, Oliver Hartmann, Andreas Bergman, Mar Medicina.2022; 58(12): 1852. CrossRef
Usefulness of High-Sensitivity Troponin I in Risk Stratification and Final Disposition of Patients with Acute Heart Failure in the Emergency Department: Comparison between HFpEF vs. HFrEF Luca Crisanti, Gabriele Valli, Elisa Cennamo, Alessandro Capolino, Paolo Fratini, Claudio Cesaro, Gloria Adducchio, Antonio De Magistris, Ferdinando Terlizzi, Maria Pia Ruggieri, Enrico Mirante, Claudio Savoriti, Kalyarat Sukruang, Valentina Valeriano, Fr Medicina.2022; 59(1): 7. CrossRef
First
Prev
