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Number of Patients Dying in EDs Declines Dramatically

SAN FRANCISCO – You and your emergency department team must be doing something right.

A study recently published in the journal Health Affairs found that, between 1997 and 2011, mortality rates for adults plummeted nearly 50% in U.S. EDs.


The study, led by researchers from the University of San Francisco, is believed to be the first national study of this type. It involved analysis of ED visit data from the National Hospital Ambulatory Medical Care Survey from 1997 to 2011.

ED mortality rates were found to have decreased from 1.48 per thousand in 1997 to 0.77 per thousand U.S. adults in 2011, a 48% reduction. Study authors posit a range of potential explanations for the mortality rate drop, including:

  • improvements in emergency medicine and prehospital care;
  • the increasing role of palliative care, which results in patients dying outside EDs in hospice settings; and
  • an overall decline in mortality trends in the U.S. population during the study period due to continued public health achievements.

More than 136 million emergency department visits took place in the United States in 2011, the latest year for which data are available, according to the U.S. Centers for Disease Control and Prevention. About 40 million of those visits were injury-related, and almost 12% resulted in hospital admission.

Compared to patients who survived, those who died tended to be older, more likely to be male and white, and were more severely ill or injured when brought to the ED. In nearly 63% of the mortality cases, patients were in cardiac arrest, unconscious, or dead on arrival, according to the study.

Overall, shortness of breath, injury, or chest pain were the most common presentations resulting in death, according to the report.

The national Centers for Disease Control and Prevention data set, which was used for the study, represents more than 1.3 billion patient visits, making it one of the largest nationally representative data sets for information on emergency conditions in the United States.

EMR- Emergency Medicine Reports - hz