Shifting Priorities in Emergency Medicine: The Rise of Hematological and Hepatological Emergencies and Their Impact on Mortality Rates

Abstract

Background Liver disease is a major global health concern, causing millions of deaths each year. Cirrhosis, a serious complication of liver disease, is a leading cause of disability and healthcare costs. Alcohol abuse is a major contributor to liver diseases, particularly in high-income countries. However, the burden of liver diseases is also rising in developing countries like India due to factors such as lifestyle changes and increasing alcohol consumption. Also, there is an increasing incidence of hematological malignancy globally. Method In this study, we analyzed admission and discharge data of patients admitted to a medical ward of a tertiary care hospital in central India. All the patients admitted to the medical ward were included in the study. The records with insufficient patient information were excluded from the study. The data was analyzed from January 2022 to December 2022. The data was analyzed every quarter in terms of counts and percentages. The variables included were the total percentage of admissions and mortality quarterly, the percentage of admissions based on disease type counts on subclassifications of disease category, and the percentage distribution of liver diseases according to gender and cause. Result A total of 1083 patients were admitted to the medicine ward from the emergency department, 929 (85.78%) were discharged, 45 (4.15%) were transferred, and 109 died, resulting in a mortality rate of 10.06%. In our study, we found that among non-infectious diseases, cardiovascular diseases still occupy the top spot with 164 (15.14%) admissions and 18 (10.98%) mortality. In comparison, the second position is held by hematological emergencies with 134 (12.37%) admissions and four (2.99%) mortality, while the third highest number of admissions was from hepatological cases with 109 (10.6%) admissions and 19 (17.43%) mortality. Conclusion Since data regarding admissions to emergency departments is very limited in India, more data is needed to draw valuable conclusions. However, we want to stress that although cardiovascular diseases are still a top priority in terms of mortality and morbidity, there is now a rising percentage of admissions of hematological and hepatological cases, with hepatological emergencies even having higher mortality.

Keywords: cardio vascular disease; emergency medicine; hematology; hepatology; mortality.