A Retrospective Analysis of the Determinants of Early In-Hospital Mortality within 24 Hours of Emergency Admission at Saraburi Hospital
Keywords:
Mortality within 24 hours, Emergency room, Determinants of mortality, Retrospective analytical studyAbstract
This retrospective analysis aimed to identify factors associated with mortality within 24 hours after admission to the emergency department (ED) at Saraburi Hospital. The study included 240 patients who visited the ED and were subsequently hospitalized between January 1, 2022, and December 31, 2024. Clinical and treatment-related data were collected from electronic medical records. Descriptive statistics, chi-square tests, and multivariable logistic regression analyses were performed to compare the patients who died within 24 hours with those who survived beyond this period.
The results showed that most of the patients were male and elderly, with common comorbidities including hypertension and diabetes mellitus. The majority were classified as Emergency Severity Index (ESI) levels 1 and 2 and required advanced life-support interventions. Factors significantly associated with 24-hour mortality included cardiopulmonary resuscitation, endotracheal intubation, oxygen therapy, central venous catheterization, fluid resuscitation, vasopressor use, intravenous steroid administration, blood component transfusion, and consultation for intensive care unit (ICU) admission. The results of multivariable logistic regression analysis demonstrated that hematologic disease was the strongest factor associated with mortality (OR = 16.4), followed by endotracheal intubation (OR = 7.5) and vasopressor use (OR = 4.4), respectively. In contrast, ICU admission was significantly associated with reduced mortality risk (OR = 0.38).
In conclusion, critically ill ED patients requiring advanced resuscitation, particularly those with hematologic diseases, have a high risk of mortality within the first 24 hours. Early severity assessment, appropriate resource allocation, and timely ICU admission may improve patient outcomes and survival during this critical period.
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