[Emergency room deaths: 3-month retrospective analysis]. / Décès survenus dans un service d'accueil et d'urgence: analyse rétrospective sur une période de 3 mois.

ABSTRACT

OBJECTIVES: Determine the characteristics of patients who died in the emergency unit and assess the number for whom care was limited or withdrawn. METHODS: A 3-month single-center retrospective study of all the patients who died in the emergency room. Bivariate analysis was used to compare the clinical characteristics of patients who died despite maximum care (MC) with those for whom care was limited (LC). RESULTS: 84 patients died during the study period 48 men and 36 women (mean age 73 +/- 18 years). Half had normal mobility (43 patients, 50%), and 35 (40%) lived at home. Nearly all (72 patients, 72%) had a severe chronic disease. In descending order, death was ascribed to neurological (n = 22, 24%), cardiac (n = 14, 15%), septic (n = 13, 14%) and respiratory (n = 9, 10%) causes. The decision was made to limit or stop active care for 73 patients (84%) and recorded in 48 case files (55%). The principal differences between patients receiving MC and LC were respectively C and D Knaus classification and their age. CONCLUSION: Death is frequent in emergency units and often strikes elderly patients with impaired mobility and severe chronic diseases. The decisions to limit or stop active care are the predominant direct cause, but their modalities warrant further exploration in a prospective study.