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. 2021 Dec 16;13(12):e20454.
doi: 10.7759/cureus.20454. eCollection 2021 Dec.

The Association Between Abnormal Vital Signs and Mortality in the Emergency Department

Jood H Simbawa  1 , Abdulkarim A Jawhari  2 , Fay Almutairi  3 , Ahlam Almahmoudi  3 , Bashair Alshammrani  3 , Raneem Qashqari  3 , Ibtihal Alattas  4
Affiliations

The Association Between Abnormal Vital Signs and Mortality in the Emergency Department

Jood H Simbawa et al. Cureus. .

Abstract

Background The emergency department (ED) receives patients from all over the world every day. Hence, using various triage scales to detect sick patients and the need for early admission are essential. Triage is a process used in the ED to prioritize patients requiring the most urgent care over those with minor injuries based on medical urgency and medical needs. These decisions may be based on patients' chief complaints at the time of their ED visit and their vital signs. Vital signs, including blood pressure (BP), respiratory rate (RR), heart rate (HR), and body temperature, are necessary tools that are traditionally used in the ED during procedures such as triage and recognizing high-risk hospital inpatients. This study aimed to determine the relationship between abnormal vital signs and mortality in the ED. Method and Material This retrospective record review study was performed at the ED of King Abdulaziz University Hospital (KAUH). Altogether, 641 patients fulfilled our inclusion criteria. Data including patients' demographics, vital signs, in-hospital mortality, triage level, and precipitating factors were collected. Results The mean age of the patients was 45.66 ± 18.43 years (69.3% females), and the majority of them had Canadian Triage and Acuity Scale (CTAS) level 3 (71.1%). The total number of in-hospital mortalities was 32 (5%). Lower systolic blood pressure (SBP) and diastolic blood pressure (DBP), high respiratory rates, and low oxygen saturation (O2SAT) were significantly associated with high mortality rates. Conclusion Abnormal vital signs play a major role in determining patient prognosis and outcomes. Triage score systems should be adjusted and carefully studied in each center according to its population.

Keywords: ctas; emergency department; heart rate; mortality rates; vital signs.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Relationship between death and Canadian Triage and Acuity Scale level
χ2 = 24.07; p < 0.001
Figure 2
Figure 2. Relationship between death and systolic and diastolic blood pressures
BP: blood pressure; SBP: systolic blood pressure; DBP: diastolic blood pressure For SBP: χ2 = 77.49; p < 0.001 For DBP: χ2 = 8.62; p = 0.035
Figure 3
Figure 3. Relationship between death and respiratory rate and oxygen saturation
RR: respiratory rate; O2SAT: oxygen saturation For RR: χ2 = 77.87; p < 0.001 For O2SAT: χ2 = 106.77; p < 0.001
See this image and copyright information in PMC

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