Association between time spent in emergency care and 30-day post-discharge mortality, England: March 2021 to April 2022 (ONS, 17 January 2025)

Summary

Report from the National Office for Statistics (ONS) showing the relationship between time spent in A&E and the odds of 30-day, post-discharge, all-cause mortality, controlling for other factors.

Content

Main points

• Of people who attended an accident and emergency (A&E) department in England between 21 March 2021 and 30 April 2022 and did not die during their A&E attendance, 1.3% died within 30 days of leaving A&E to return home or be admitted to inpatient care; this analysis covers patients who required non-immediate care in an emergency department.
• At two hours of total time spent in A&E from arrival to discharge for non-immediate care, 0.02% of patients aged 20 years died post-discharge, increasing to 0.1% for patients aged 40 years, 0.3% for patients aged 60 years and 0.8% for patients aged 80 years; this was after adjusting for a range of other socio-demographic and clinical factors related to post-discharge death.
• The adjusted risk of post-discharge death increased with total time spent in A&E after approximately two hours for patients requiring non-immediate care.
• Compared with patients requiring non-immediate care who spent two hours in A&E, the odds of post-discharge death were: 1.1 times higher for those who spent three hours in A&E; 1.6 times higher for those who spent six hours in A&E; 1.9 times higher for those who spent nine hours in A&E; and 2.1 times higher for those who spent 12 hours in A&E.
• The relationship between total time spent in A&E and post-discharge death among patients requiring non-immediate care varied by age, region, chief complaint and admission status.
• The relative difference in the risk of post-discharge death after 12 hours in A&E compared with two hours in A&E was greatest for: younger patients (for example, the odds at 12 hours were 4.6 times higher than at two hours for patients aged 20 years), those in London (2.7 times higher), those who attended A&E for reasons to do with their eyes (7.9 times higher), and those who were not admitted to hospital for inpatient care after visiting A&E (2.8 times higher).