A retrospective chart review of adult mortality characteristics of patients presenting to a principal tertiary emergency department.

AIM: To determine the incidence of death after arrival to one metropolitan emergency department (ED) for each triage code, day of arrival, diagnosis and length of stay.

METHOD: A 12-month retrospective chart review was conducted in a 550 bed principal referral hospital of all patients that presented to the ED and subsequently died. The ED annual attendance rate for the study year was 46,017 patients. The data collected included patient demographics, diagnosis, triage code, length of stay and ward disposition. The data are expressed as proportions, percentages, frequencies or the statistic chi-square (chi(2)). The proportion of ED deaths also examined included those patients admitted through the ED to a ward area.

RESULTS: The ED mortality rate for the study period was 1.3% (n=595). One hundred and twenty-three patients (21%) died in the unit, while 472 (79%) were admitted through the ED to a ward area. The total annual hospital mortality rate was 1.7% (n=790). The mean age of patients that died was 76 years. Of ED deaths, 329 (55%) were male and 266 (45%) female. Triage code 1 (60%) was allocated more commonly to patients that died in the ED compared with triage code 3 (46%) for ED-Ward deaths.

CONCLUSIONS: Examination of ED mortality rate provides a deeper understanding of service utilisation and nursing staff work performance. Triage codes are beneficial in evaluating ED services, casemix, policies and quality assurance activities, but the application of this indicator to in-patient services appears limited.