Shock in the emergency department; a 12 year population based cohort study

doi:10.1186/s13049-016-0280-x

Paper

Shock in the emergency department; a 12 year population based cohort study

Published Jun 30, 2016 · DOI · J. G. Holler, D. Henriksen, S. Mikkelsen

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

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Abstract

BackgroundThe knowledge of the frequency and associated mortality of shock in the emergency department (ED) is limited. The aim of this study was to describe the incidence, all-cause mortality and factors associated with death among patients suffering shock in the ED.MethodsPopulation-based cohort study at an University Hospital ED in Denmark from January 1, 2000, to December 31, 2011. All patients aged ≥18 years living in the hospital catchment area with a first time ED presentation with shock (n = 1646) defined as hypotension (systolic blood pressure (SBP) ≤100 mmHg)) and ≥1 organ failures. Outcomes were annual incidence per 100,000 person-years at risk (pyar), all-cause mortality at 0–7, and 8–90 days and risk factors associated with death.ResultsWe identified 1646 of 438,191 (0.4 %) ED patients with shock at arrival. Incidence of shock increased from 53.8 to 80.6 cases per 100,000 pyar. The 7-day, and 90-day mortality was 23.1 % (95 % CI: 21.1–25.1) and 40.7 % (95 % CI: 38.3–43.1), respectively. Independent predictors of 7-day mortality were: age (adjusted HR 1.03 (95 % CI: 1.03–1.04), and number of organ failures (≥3 organ failures; adjusted HR 3.13 95 % CI: 2.28–4.30). Age, comorbidity level and number of organ failure were associated with 90-day mortality.ConclusionShock is a frequent and critical finding in the ED, carrying a 7- and, 90- day mortality of 23.1 and 40.7 %, respectively. Age and number of organ failures are independent prognostic factors for death within 7 days, whereas age, comorbidity and organ failures are of significance within 8–90 days.

Observational StudyRigorous Journal

Study Snapshot

Shock is a common and critical finding in emergency departments, with a 7-day mortality rate of 23.1 percent and a 90-day mortality rate of 40.7 percent, with age and number of organ failures being independent prognostic factors.

Population
Older adults (50-71 years)
Sample size
24
Methods
Observational
Outcomes
Body Mass Index projections
Results
Social networks mitigate obesity in older groups.

Shock in the emergency department; a 12 year population based cohort study

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