Death Within 48 Hours of Admission to the Emergency Department: The Value of Autopsy

To identify factors that contribute to patient death within 48hours of admission to the emergency department. A retrospective study of the patients who died within 48hours of admission to the emergency department, from the years 2000 to 2003. The antemortem diagnosis and postmortem diagnosis were compared. A total of 189 autopsies were performed. The mean age at death for men (41.4years) was lower than that for women (48.6) (p=0.02). In both men and women, cardiac system involvement was the leading cause of death (27.5%), with myocardial infarction at 21.2%. The other common causes of death for both genders were blunt trauma (20.1%), intoxication with alcohol and/or other drugs (13.8%), penetrating trauma (gunshot or stab injuries) (13.2%), pulmonary thromboembolism (7.9%), and death caused by other respiratory causes (7.4%). Death caused by pulmonary thromboembolism was more common in women, whereas death caused by strokes, burns, and penetrating trauma were seen almost exclusively in men. Our study found a considerable concordance between the presumed antemortem cause of death and the postmortem findings. Although the mean age of death caused by myocardial infarction in our study was 52.45years, MI caused a significant number of deaths among adults younger than 40years of age.