Death within 8 days after discharge to home from the emergency department.
BACKGROUND
Deaths within 8 days after discharge have, in previous studies, been evaluated retrospectively based on review of hospital records and the cause of death. The aim of the study was to evaluate the association of death within 8 days after discharge to home from the emergency department with a non-causative diagnosis in a prospective cohort study.


METHODS
The records from the emergency department were filed by personal identification number and included information on gender, age, admission, discharge and diagnosis. The cause of death was obtained from a nation-wide registry by record linkage. Mortality per 100,000 within 8 days and the hazard ratio and 95% confidence intervals (CIs) were calculated for all causes of death in a time-dependent analysis.


RESULTS
A non-causative diagnosis had been given to 11% of those who died within 8 days after discharge home. The mortality per 100,000 within 8 days was 208.5, within 15 days 347.4 and within 30 days 648.6. In the analysis of deaths within 8 days, the hazard ratio was higher for men than women and increasing age was significantly associated with high mortality. The hazard ratio for non-causative diagnosis was 0.44 (95% CI 0.20-0.96) as compared to causative diagnosis, adjusted for gender and age.


CONCLUSIONS
The mortality rate within 8 days of discharge found in the present study is considerably higher than findings in previous studies. Death shortly after discharge of patients with non-causative diagnosis may indicate a misjudgement of the patients' condition at the time of discharge.
Office of Education, Research and Development, Landspitali University Hospital, Reykjavik, Iceland.
Oddny S
OS
Gunnarsdottir
Vilhjalmur
V
Rafnsson
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D015331:Cohort Studies; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009026:Mortality; D010351:Patient Discharge / Q000706:statistics & numerical data*; D011446:Prospective Studies; D055815:Young Adult