Risk Factors and Causes of Short-Term Mortality after Emergency Department Discharge in Older Patients: Using Nationwide Health Insurance Claims Data
Background The purpose of this study was to identify the risk factors and causes of short-term mortality after emergency department (ED) discharge in older patients. Methods This population-based cohort study used nationwide health insurance claims data in Korea from 2008 to 2014. The causes of deat...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korea Geriatrics Society
2019-09-01
|
| Series: | Annals of Geriatric Medicine and Research |
| Subjects: | |
| Online Access: | http://www.e-agmr.org/upload/pdf/agmr-19-0029.pdf |
| _version_ | 1811212290311061504 |
|---|---|
| author | Seunggu Na Yongil Cho Tae Ho Lim Hyunggoo Kang Jaehoon Oh Byuk Sung Ko |
| author_facet | Seunggu Na Yongil Cho Tae Ho Lim Hyunggoo Kang Jaehoon Oh Byuk Sung Ko |
| author_sort | Seunggu Na |
| collection | DOAJ |
| description | Background The purpose of this study was to identify the risk factors and causes of short-term mortality after emergency department (ED) discharge in older patients. Methods This population-based cohort study used nationwide health insurance claims data in Korea from 2008 to 2014. The causes of death and diagnoses of patients who died within 1 week after discharge from EDs (1-week ED death) were obtained. The risk factors for 1-week ED death were calculated using Cox proportional hazard regression analyses. Results The rate of 1-week ED death was 0.5% among 133,251 individuals aged ≥65 years discharged from EDs. In multivariate analysis, the top five ED discharge diagnoses associated with an increased risk of 1-week ED death were hypotension and vascular disease (adjusted hazard ratio [aHR]=5.11; 95% confidence interval [CI], 3.03–8.63), neoplasm (aHR=4.89; 95% CI, 3.77–6.35), coronary artery disease (aHR=3.83; 95% CI, 2.73–5.39), dyspnea (aHR=3.41; 95% CI, 2.48–4.68), and respiratory disease (aHR=2.25; 95% CI, 1.73–2.92). The most common causes of 1-week ED death were neoplasm (14.8%), senility (13.8%), and cerebrovascular disease (11.7%). Conclusion Neoplasm, coronary artery disease, and respiratory disease were the discharge diagnoses associated with an increased risk of short-term mortality after ED discharge. Neoplasm was the leading cause of short-term mortality after ED discharge in older patients. |
| first_indexed | 2024-04-12T05:25:34Z |
| format | Article |
| id | doaj.art-5ead4aa180bf46bbab76983869516287 |
| institution | Directory Open Access Journal |
| issn | 2508-4798 2508-4909 |
| language | English |
| last_indexed | 2024-04-12T05:25:34Z |
| publishDate | 2019-09-01 |
| publisher | Korea Geriatrics Society |
| record_format | Article |
| series | Annals of Geriatric Medicine and Research |
| spelling | doaj.art-5ead4aa180bf46bbab769838695162872022-12-22T03:46:17ZengKorea Geriatrics SocietyAnnals of Geriatric Medicine and Research2508-47982508-49092019-09-0123313314010.4235/agmr.19.0029887Risk Factors and Causes of Short-Term Mortality after Emergency Department Discharge in Older Patients: Using Nationwide Health Insurance Claims DataSeunggu Na0Yongil ChoTae Ho Lim1Hyunggoo Kang2Jaehoon Oh3Byuk Sung Ko4 Department of Emergency Medicine, Hanyang University College of Medicine, Seoul, Korea Department of Emergency Medicine, Hanyang University College of Medicine, Seoul, Korea Department of Emergency Medicine, Hanyang University College of Medicine, Seoul, Korea Department of Emergency Medicine, Hanyang University College of Medicine, Seoul, Korea Department of Emergency Medicine, Hanyang University College of Medicine, Seoul, KoreaBackground The purpose of this study was to identify the risk factors and causes of short-term mortality after emergency department (ED) discharge in older patients. Methods This population-based cohort study used nationwide health insurance claims data in Korea from 2008 to 2014. The causes of death and diagnoses of patients who died within 1 week after discharge from EDs (1-week ED death) were obtained. The risk factors for 1-week ED death were calculated using Cox proportional hazard regression analyses. Results The rate of 1-week ED death was 0.5% among 133,251 individuals aged ≥65 years discharged from EDs. In multivariate analysis, the top five ED discharge diagnoses associated with an increased risk of 1-week ED death were hypotension and vascular disease (adjusted hazard ratio [aHR]=5.11; 95% confidence interval [CI], 3.03–8.63), neoplasm (aHR=4.89; 95% CI, 3.77–6.35), coronary artery disease (aHR=3.83; 95% CI, 2.73–5.39), dyspnea (aHR=3.41; 95% CI, 2.48–4.68), and respiratory disease (aHR=2.25; 95% CI, 1.73–2.92). The most common causes of 1-week ED death were neoplasm (14.8%), senility (13.8%), and cerebrovascular disease (11.7%). Conclusion Neoplasm, coronary artery disease, and respiratory disease were the discharge diagnoses associated with an increased risk of short-term mortality after ED discharge. Neoplasm was the leading cause of short-term mortality after ED discharge in older patients.http://www.e-agmr.org/upload/pdf/agmr-19-0029.pdfAgedMortalityEmergency departmentsRisk factors |
| spellingShingle | Seunggu Na Yongil Cho Tae Ho Lim Hyunggoo Kang Jaehoon Oh Byuk Sung Ko Risk Factors and Causes of Short-Term Mortality after Emergency Department Discharge in Older Patients: Using Nationwide Health Insurance Claims Data Annals of Geriatric Medicine and Research Aged Mortality Emergency departments Risk factors |
| title | Risk Factors and Causes of Short-Term Mortality after Emergency Department Discharge in Older Patients: Using Nationwide Health Insurance Claims Data |
| title_full | Risk Factors and Causes of Short-Term Mortality after Emergency Department Discharge in Older Patients: Using Nationwide Health Insurance Claims Data |
| title_fullStr | Risk Factors and Causes of Short-Term Mortality after Emergency Department Discharge in Older Patients: Using Nationwide Health Insurance Claims Data |
| title_full_unstemmed | Risk Factors and Causes of Short-Term Mortality after Emergency Department Discharge in Older Patients: Using Nationwide Health Insurance Claims Data |
| title_short | Risk Factors and Causes of Short-Term Mortality after Emergency Department Discharge in Older Patients: Using Nationwide Health Insurance Claims Data |
| title_sort | risk factors and causes of short term mortality after emergency department discharge in older patients using nationwide health insurance claims data |
| topic | Aged Mortality Emergency departments Risk factors |
| url | http://www.e-agmr.org/upload/pdf/agmr-19-0029.pdf |
| work_keys_str_mv | AT seungguna riskfactorsandcausesofshorttermmortalityafteremergencydepartmentdischargeinolderpatientsusingnationwidehealthinsuranceclaimsdata AT yongilcho riskfactorsandcausesofshorttermmortalityafteremergencydepartmentdischargeinolderpatientsusingnationwidehealthinsuranceclaimsdata AT taeholim riskfactorsandcausesofshorttermmortalityafteremergencydepartmentdischargeinolderpatientsusingnationwidehealthinsuranceclaimsdata AT hyunggookang riskfactorsandcausesofshorttermmortalityafteremergencydepartmentdischargeinolderpatientsusingnationwidehealthinsuranceclaimsdata AT jaehoonoh riskfactorsandcausesofshorttermmortalityafteremergencydepartmentdischargeinolderpatientsusingnationwidehealthinsuranceclaimsdata AT byuksungko riskfactorsandcausesofshorttermmortalityafteremergencydepartmentdischargeinolderpatientsusingnationwidehealthinsuranceclaimsdata |