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Background <p>There is much focus on the management of the acute emergency medical admission; however, comparative outcome data over long time periods are sparse.</p> Aim <p>We report all the outcomes of emergency admissions over 23&#xa0;years (2002–2024).</p> Methods <p>Demographic and clinical details are described. Predictors of 30-day in-hospital mortality were analysed with logistic and Cox regression.</p> Results <p>The 2002–2024 cohort consisted of 186,004 admissions in 95,192 patients. The 30-day in-hospital mortality per admission averaged 3.8% (95% CI 3.7% to 3.9%); there was a relative risk reduction (RRR) between 2002 and 2024 of 55.3%, from 5.5% to 2.4% (<i>p</i> = 0.001), with a calculated number needed to treat (NNT) of 33. Per patient mortality (single admission only considered; last admission if &gt; 1) averaged 7.5% (95% CI 7.4% to 7.7%); there was a RRR of 77.9% between 2002 and 2024, from 13.1% to 2.9% (<i>p</i> = 0.001) with NNT of 9.9. Total in-hospital deaths were 14,092 at respective age for males of 73.6 (SEM 0.12) and females of 79.4 (SEM 0.11). The strongest predictors of short-term 30-day in-hospital mortality were being older (&gt; 70 years)—OR 2.05 (95%CI 1.94, 2.18) and the acute illness severity score 1.91 (95%CI 1.85, 1.96). Other predictors were the Charlson Index 1.32 (95% CI 1.28, 1.37) and a primary neurological MDC (major disease category) 1.18 (95% CI 1.09, 1.27).</p> Conclusion <p>The 30-day in-hospital mortality for emergency medical admissions has improved over time.</p>

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Predictors of acute hospital mortality from a 23-year database of emergency medical admissions

  • 期刊论文

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  • 发表日期：

    2025年7月29日

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  • Richard Conway,
  • Declan Byrne,
  • Deirdre O’Riordan,
  • Bernard Silke

摘要

Background

There is much focus on the management of the acute emergency medical admission; however, comparative outcome data over long time periods are sparse.

Aim

We report all the outcomes of emergency admissions over 23 years (2002–2024).

Methods

Demographic and clinical details are described. Predictors of 30-day in-hospital mortality were analysed with logistic and Cox regression.

Results

The 2002–2024 cohort consisted of 186,004 admissions in 95,192 patients. The 30-day in-hospital mortality per admission averaged 3.8% (95% CI 3.7% to 3.9%); there was a relative risk reduction (RRR) between 2002 and 2024 of 55.3%, from 5.5% to 2.4% (p = 0.001), with a calculated number needed to treat (NNT) of 33. Per patient mortality (single admission only considered; last admission if > 1) averaged 7.5% (95% CI 7.4% to 7.7%); there was a RRR of 77.9% between 2002 and 2024, from 13.1% to 2.9% (p = 0.001) with NNT of 9.9. Total in-hospital deaths were 14,092 at respective age for males of 73.6 (SEM 0.12) and females of 79.4 (SEM 0.11). The strongest predictors of short-term 30-day in-hospital mortality were being older (> 70 years)—OR 2.05 (95%CI 1.94, 2.18) and the acute illness severity score 1.91 (95%CI 1.85, 1.96). Other predictors were the Charlson Index 1.32 (95% CI 1.28, 1.37) and a primary neurological MDC (major disease category) 1.18 (95% CI 1.09, 1.27).

Conclusion

The 30-day in-hospital mortality for emergency medical admissions has improved over time.