Clinical profile and outcome of the patients presenting to the resuscitation room of the emergency department in a Tertiary Care Hospital of South India

Abstract

Background: The sickest patients who visit the emergency department (ED) are triaged as priority one based on guidelines. To improve the quality of Emergency medicine (EM) care, a better understanding of patients is needed; hence, this study was done on priority one patients of the ED. Materials and Methods: This retrospective study included all priority one patients during a 4-month period (February, May, September, and December), over 1 year (2017). Demographic details, vital signs at the time of presentation, and details of disposition were noted. Results: Among 2333 priority one patients, majority (89.3%) had non trauma-related diseases, while only 10.7% had trauma as the cause of disease. Males were predominant (64%) and females accounted for 36%. Adults were more than half (59.16%), followed by the geriatric age group. Bradycardia was noted in 6.4% (149) patients, while 52.1% (1212) had tachycardia and 29.7% of the population presented with hypotension. Breathlessness was the most common complaint (44.6%); trauma specialty departments were referred to include neurosurgery (43.1%) and orthopedics (27.5%). Broader specialties such as general medicine and general surgery had majority of their spectrum-related cases referred to them, 44.9% (n = 716) and 39.3% (n = 50), respectively. More than a quarter of patients (27.2%) were discharged from the ED, one-third (68.1%) of the patients were discharged from the hospital overall, and 7.4% succumbed to death. Conclusion: The patient demographics and other characteristics identified by this study help us to guide and shape Indian EM training programs, infrastructure, and faculty development, to more accurately reflect the burden of acute disease in India.