Causes of death in the Emergency Department: a retrospective monocentric study.

Abstract

The Emergency Department (ED) serves as a critical entry point for patients with life-threatening conditions, yet mortality within this setting remains a significant clinical and epidemiological concern. This retrospective monocentric study investigates the primary causes of death in the ED of Emergency Municipal Hospital, Timişoara, Romania, over a five-year period (2019-2023). A total of 63 cases were analyzed, integrating clinical data at the time of presentation with post-mortem pathological findings to ensure diagnostic accuracy. Results indicate that irreversible cardiac arrest (ICA) constituted the predominant cause of mortality, with non-shockable rhythms accounting for 88.88% of cases - asystole (80.35%) and pulseless electrical activity (19.65%) - while shockable rhythms (ventricular fibrillation and pulseless ventricular tachycardia) were observed in only 11.12% of cases. Among non-cardiac etiologies, septic shock (31.74%) and respiratory failure (17.46%) were the most prevalent contributors. These findings highlight the need for improved diagnostic methodologies, optimized resuscitation strategies, and enhanced resource allocation within emergency settings. This study underscores the necessity for systematic mortality documentation, evidence-based intervention protocols, and targeted management strategies to mitigate preventable deaths in the ED. The integration of clinical and autopsy-based data offers valuable insights into pathophysiological mechanisms contributing to ED mortality and provides a foundation for future research aimed at improving emergency medical outcomes.