Evidence map›Paper›PMID 31489186›Full record

Observational studyJournal of global health2019

Presenting complaints and mortality in a cohort of 22 000 adult emergency patients at a local hospital in Nepal.

Samita Giri, Tormod Rogne, Oddvar Uleberg, Eva Skovlund, Sanu Krishna Shrestha, Rajendra Koju, Jan Kristian Damås, Erik Solligård, Kari R Risnes

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of global health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 2 countries.

Samita GiriDepartment of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.
Tormod RogneDepartment of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.
Oddvar UlebergDepartment of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.
Eva SkovlundDepartment of Public Health and Nursing, Norwegian University of Science and Technology, NTNU, Trondheim, Norway.
Sanu Krishna ShresthaDepartment of Emergency, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Nepal.
Rajendra KojuDepartment of Internal Medicine, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Nepal.
Jan Kristian DamåsGemini Center for Sepsis Research, St. Olav's hospital, Trondheim University Hospital, Trondheim, Norway.
Erik SolligårdDepartment of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.
Kari R RisnesDepartment of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
Norwegian University of Science and Technology · NODhulikhel Hospital · NPSt Olav's University Hospital · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is a need to develop sustainable emergency health care systems in low-resource settings, but data that analyses emergency health care needs in these settings are scarce. We aimed at assessing presenting complaints (PCs) and post-discharge mortality in a large emergency department population in Nepal.

methodsCharacteristics of adult patients who entered the emergency department (ED) in a hospital in Nepal were prospectively recorded in the local emergency registry from September 2013 until December 2016. To assess post-ED mortality, patient households were followed-up by telephone interviews at 90 days.

resultsIn 21892 included adults, the major PC categories were injuries (29%), abdominal complaints (23%), and infections (16%). Median age was 40 years and sex distribution was balanced. Among 3793 patients followed at 90 days, 8% had died. For respiratory and cardiovascular PCs, 90-day mortality were 25% and 23%. The highest mortality was in individuals with known chronic lung disease, in this group 32% had died by 90 days of ED discharge, regardless of PC. In women, illiteracy compared to literacy (adjusted odds ratio (aOR) = 7.0, 95% confidence interval (CI) = 2.1-23.6) and being both exposed to tobacco-smoking and traditional cooking stove compared to no smoke (aOR = 2.8, 95% CI = 1.6-4.9) were associated with mortality. The mortality was much higher among family-initiated discharged patients (17%, aOR = 5.4, 95% CI = 3.3-8.9) compared to doctor-initiated discharged (3%).

conclusionsOur report suggests that nearly one in ten patients seeking emergency health care died within 90 days. This finding is alarming and novel. Post-discharge studies need to be replicated and appropriate follow-up programs in low-resource settings where primary health care is underdeveloped are urgently needed.

Indexed as

AdultAgedEmergency Service, HospitalFemaleHospitals, UniversityHumansMaleMiddle AgedMortalityNepalProspective Studies

Identifiers

PMID31489186
PMCPMC6708590
OpenAlexW2969960674

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.