The effect of dead-on-arrival and emergency department death
We investigated the effect of inclusion and exclusion of emergency department (ED) deaths (dead on arrival [DOA] and died in ED [DIE]) on analyses of overall risk-adjusted trauma center performance. Methods: Data for patients admitted to 65 Trauma Quality Improvement Program hospitals during the 2009 calendar year was used.
DEFECTIVE ON ARRIVAL POLICY
DOA: defective on arrival – A product is considered DOA only if it fails to function at the time of first installation DOA certificate: Poly form PGS3.1. provided as confirmation of a DOA product
The effect of dead-on-arrival and emergency department death
Of 224 patients, 14 (6.2%) had a documented time of death of more than 30 minutes after ED arrival despite being recorded as DOA. Forty-one trauma centers (63%) changed rank by three positions or less. Ten trauma centers changed their quartile ranking by a single quartile, but no centers were found to change quartile rank more than one quartile.
The effect of dead-on-arrival and emergency department death
(dead on arrival [DOA] and died in ED [DIE]) on analyses of overall risk-adjusted trauma center performance. METHODS: Data for patients admitted to 65 Trauma Quality Improvement Program hospitals during the 2009 calendar year was used. A logistic regression model was developed to estimate risk-adjusted mortality.
Patient Characteristics of Persons Dead on Arrival Received
The death certificate is a legal document that serves as documentation that a person is dead. Local Emergency Nursing Care of DOA. North Zealand Hospital is a university hospital located in the capital region of Denmark. When a DOA person is received in the emergency department, and if the police permit, the emergency nurse assumes care of the
- Is inclusion of DOA patients in risk-adjusted analysis of mortality appropriate?
- Inclusion of DOA and DIE patients in risk-adjusted analysis of mortality is appropriate and eliminates the bias introduced by exclusion of ED deaths owing to misuse of the DOA classification. Level of evidence: Prognostic/epidemiologic study, level III.
- How long does a DOA patient die?
- The median time to death for all DOA patients was 4 minutes. However, 14 (6.2%) of 224 patients had a documented time of death >30 minutes after ED arrival despite being recorded as DOA. Five trauma centers had data demonstrating that ≥50% of their reported DOA patients had a recorded time of death more than 30 minutes after presenting to the ED.
- Are emergency department deaths excluded from risk-adjusted trauma center performance?
- In previous analyses, patients who died in the emergency department were excluded. We investigated the effect of inclusion and exclusion of emergency department (ED) deaths (dead on arrival [DOA] and died in ED [DIE]) on analyses of overall risk-adjusted trauma center performance.
- Does inclusion of DOA & die patients affect outlier status?
- In comparison , inclusion of DOA and DIE patients modified the outlier status of 9% of centers, which is less than the 10% rate of such an occurrence happening by chance alone when utilizing a 90% confidence interval (CI).
- Why should we use DOA instead of OHCA?
- The use of DOA, rather than OHCA, has important implications for how we think about these patients. The focus shifts to patients who arrive in the emergency department and the subsequent impact on care, particularly for emergency nurses who have a critical role in resuscitation and in sup-porting the families of DOA patients.
- What is a 'DOA' & 'bid'?
- There is no consensus regarding a universal definition of DOA, that also described as brought in dead (BID); however, according to National Trauma Data Standard (NTDS), the patient is declared DOA with no resuscitation attempt or with minimal noninvasive procedures done and be declared dead within the 15 min of arrival .
