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Background: The knowledge of the frequency and associated mortality of shock in the emergency department (ED) is limited. The aim of this study was to describe the incidence, all-cause mortality and factors associated with death among patients suffering shock in the ED. Methods: Population-based cohort study at an University Hospital ED in Denmark from January 1, 2000, to December 31, 2011. All patients aged ≥18 years living in the hospital catchment area with a first time ED presentation with shock (n = 1553) defined as hypotension (systolic blood pressure (SBP) ≤100 mmHg)) and ≥1 organ failures. Outcomes were annual incidence per 100,000 person-years at risk (pyar), all-cause mortality at 0–7, and 8–90 days and risk factors associated with death. Results: We identified 1553 of 438,191 (0.4%) ED patients with shock at arrival. Incidence of shock increased from 53.6–74.8 cases per 100,000 pyar. The 7-day, and 90-day mortality was 23.3% (95% CI: 21.2–25.4) and 41.1% (95% CI: 38.6–43.5), respectively. Independent predictors of 7-day mortality were: age (adjusted HR 1.03 (95% CI: 1.03–1.04), and number of organ failures (≥3 organ failures; adjusted HR 3.30 95% CI: 2.33–4.66). Age, comorbidity level and number of organ failure were associated with 90-day mortality. Conclusion: Shock is a frequent and critical finding in the ED, carrying a 7and, 90day mortality of 23.3% and 41.1%, respectively. Age and number of organ failures are independent prognostic factors for death within 7 days, whereas age, comorbidity and organ failures are of significance within 8–90 days.

Erratum to: Shock in the emergency department; a 12 year population based cohort study