Title: Role of surveillance and prevention in hospital acquired infection and mortality
Authors: Dr Upendra Baitha, Dr Vaibhav Deorari, Dr Nikhil A Kumar, Dr Pankaj Jorwal, Dr Piyush Ranjan, Dr Arvind Kumar, Dr Manish Soneja, Prof. Ashutosh Biswas
DOI: https://dx.doi.org/10.18535/jmscr/v8i12.33
Abstract
Background: Mortality analysis is important for health planning and resource allocation. These data are essential for low and middle-income countries like India. Globally, the adult mortality rate was 175.45 deaths per 1000 males and 121.19 deaths per 1000 females in 2018 whereas in India it was 204 death per 1000 for males and 147 deaths per 1000 for females. Tuberculosis, respiratory infections and diarrhoea form a large proportion of in-hospital deaths. Causes of death analysed through hospital mortality data can provide an idea about the epidemiological trends as they are complete and accurate.
Methods: We retrospectively analysed the records of all admitted patients who died in the Department of Medicine at All India Institute of Medical Sciences, New Delhi, between the periods of December 2017 to November 2018. Patients with age less than 14 years of age and those with incomplete records were excluded. Cause of death was classified into infectious, cardiovascular system, respiratory system, gastrointestinal system, neurological system and others.
Results: Out of 205 deaths, 132 (64.4%) were males with a mean age of 49.3 ± 16.2 years, and 73(35.6%) were females with a mean age of 48.2 ± 16.9 years. The interval between admission and deaths ranged from 2 hours to 74 days, with a median duration of 4 days. The leading causes of death were infectious and parasitic diseases (57.6%), cardiovascular (17.6%), gastrointestinal diseases (10.7%) and neurological diseases (4.9%).
Conclusion: In our study, infections were the most common cause of death (57.6%), followed by cardiovascular causes (17.6%). In-hospital complications like hospital/ventilator-associated pneumonia, catheter-associated urinary tract infections and acute coronary syndromes together cause 29.26% of deaths in the medical ward. Hospital derived mortality data are an important component of health statistics and regular auditing helps in policy making.
Keywords: Infectious disease, epidemiology, public health.
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