PATTERN OF EMERGENCY DEPARTMENT ADMISSIONS AND THEIR CLINICAL OUTCOMES AT A TERTIARY CARE TEACHING HOSPITAL

Abstract

Background: Emergency departments (EDs) provide timely evaluation and management of patients with acute medical, surgical, and traumatic conditions. Understanding admission patterns and patient outcomes is essential for optimizing emergency care services, resource allocation, and quality improvement. Aim: To evaluate the pattern of emergency department admissions and their clinical outcomes at a tertiary care teaching hospital. Materials and Methods: This hospital-based cross-sectional observational study included 425 consecutive patients presenting to the emergency department over a 12-month period. Demographic characteristics, mode of arrival, presenting complaints, diagnostic categories, comorbidities, triage status, emergency interventions, duration of ED stay, and final clinical outcomes were recorded using a predesigned case-record form. Data were analyzed using descriptive statistics, while associations between categorical variables were assessed using the Chi-square or Fisher's exact test. A p-value <0.05 was considered statistically significant. Results: The mean age of the participants was 43.8±19.6 years, and the majority were males (59.8%). Medical emergencies constituted the largest diagnostic category (40.5%), followed by trauma (19.8%) and surgical emergencies (14.8%). Fever (19.8%) and trauma (18.6%) were the most common presenting complaints. Nearly half of the patients (47.5%) were classified as green triage, whereas 13.2% required immediate resuscitation. Intravenous fluid administration (67.1%) and oxygen therapy (28.5%) were the most common emergency interventions. Overall, 39.5% of patients were discharged directly from the ED, 39.3% required ward admission, 9.6% required ICU admission, and the overall mortality was 1.7%. Clinical outcomes showed a significant association with triage category (p<0.001), with red and yellow triage patients experiencing higher rates of hospital admission, ICU transfer, and mortality than green triage patients. Conclusion: Medical emergencies represented the predominant cause of ED admissions, while higher triage acuity was strongly associated with adverse clinical outcomes. Efficient triage, prompt emergency interventions, and appropriate resource utilization are crucial for improving patient outcomes and enhancing emergency care services in tertiary care teaching hospitals.