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 Table of Contents  
ORIGINAL ARTICLE
Year : 2018  |  Volume : 7  |  Issue : 2  |  Page : 80-82

Mortality trends in a tertiary care hospital in Mysore


1 Junior Resident, JSS Medical College, Mysore, Karnataka, India
2 Professor of Medicine, JSS Medical College, Mysore, Karnataka, India

Date of Web Publication2-May-2018

Correspondence Address:
Dr. C Deepak
Flat No 101, Sienna Apartment, Chamundipuram Circle, Mysore, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijhas.IJHAS_57_1

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  Abstract 


AIM: The aim of this study is to find out the various causes of mortality in a tertiary care hospital over a 1-year period.
MATERIALS AND METHODS: All deaths occurring in the study period were retrospectively analyzed by analyzing the hospital records from the Medical Records Department for causes of death and various epidemiological parameters such as age and sex.
RESULTS: A total of 1028 deaths were included the study. Deaths were more in males than females. More deaths were observed in the fifth and sixth decades of life. The maximum deaths, i.e., 356 were due to sepsis (34.6%) of which pneumonia was the cause in a majority of sepsis-related deaths (36.51%). Cardiovascular causes of death were 184 (17.89%) of which a majority of 130 (70.65%) were related to ischemic heart disease. The other causes of deaths included 137 (13.3%) from road traffic accidents, 117 (11.3%) due to cerebrovascular accidents, 73 (7.1%) due to gastrointestinal tract-related causes, 58 (5.64%) due to primary renal diseases, 45 (4.37%) from chronic respiratory ailments, 32 (3.11%) due to malignancies, 18 (1.75%) due to poisonings, and 4 (0.38%) deaths due to hematological disorders.
CONCLUSION: The most common cause of overall mortality was sepsis followed by cardiac causes. Road traffic accidents also significantly contributed to the overall mortality. Steps are needed to be taken to educate the medical fraternity and the people about the prevalence and preventive strategies for communicable and noncommunicable diseases.

Keywords: Mortality, tertiary care hospital, sepsis


How to cite this article:
Deepak C, Krishna Kishore RV, Babu M S. Mortality trends in a tertiary care hospital in Mysore. Int J Health Allied Sci 2018;7:80-2

How to cite this URL:
Deepak C, Krishna Kishore RV, Babu M S. Mortality trends in a tertiary care hospital in Mysore. Int J Health Allied Sci [serial online] 2018 [cited 2018 Sep 19];7:80-2. Available from: http://www.ijhas.in/text.asp?2018/7/2/80/231691




  Introduction Top


To live long and healthy is a fundamental aspect of human life. Wide disparities exist in the levels of mortality across countries and regions. Those differences reflect inequalities in access to food, safe drinking water, sanitation, medical care, and other basic human needs. They also reflect differences in risk factors, behave ioral choices, and societal contexts that affect the survival of individuals. Recent decades have witnessed tremendous advancements in health and survival worldwide. Great heterogeneity exists across the world's regions regarding which specific causes of death were most responsible for the survival gaps. Mortality statistics are essential for a meaningful planning of health care and allocation of resources. The present study was aimed at finding out the various causes of mortality in a tertiary care hospital over a 1-year period from 2014 to 2015.


  Materials and Methods Top


This was a hospital-based, retrospective study carried out in 1800-bedded tertiary care JSS Medical college hospital based in Mysore, Karnataka state, which caters to both urban and rural population from 2014 to 2015. All deaths occurring during this period were retrospectively analyzed by analyzing the hospital records from the Medical Records Department for causes of death and various epidemiological parameters such as age and sex. Deaths in the pediatric age group <12 years were excluded from the study. Deaths which had occurred outside the hospital or brought dead were excluded from the study. The data were analyzed in the form of percentages. Ethical clearance of the study was obtained from the Institutional Ethical Committee.


  Results Top


The total number of deaths in the study period was 1575. A total of 547 deaths were excluded from the study which included 195 deaths in pediatrics, 11 in obstetrics and gynecology, 112 in surgery, and 229 deaths which were brought dead cases to the emergency department. A total of 1028 deaths were included in the study. Deaths were more in males than females. More deaths were observed in the fifth and sixth decades of life [Table 2]. The maximum deaths of 356 were due to sepsis (34.6%) [Table 1] of which pneumonia was the cause in a majority of sepsis-related deaths (36.51%). Cardiovascular causes of death were 184 (17.89%) out of which a majority of 130 (70.65%) were related to ischemic heart disease. The other causes of deaths included 137 (13.3%) from road traffic accidents, 117 (11.3%) due to cerebrovascular accidents, 73 (7.1%) due to gastrointestinal tract-related causes, 58 (5.64%) due to primary renal diseases, 45 (4.37%) from chronic respiratory ailments, 32 (3.11%) were related to malignancies, 18 (1.75%) due to poisonings, and 4 (0.38%) deaths were related to hematological disorder.
Table 1: Distribution of causes of death

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Table 2: Age group distribution of causes of death

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  Discussion Top


Hospital-based mortality analysis reflects the causes of major illness, care-seeking behavior of the community, and the standard of care being provided. This was a retrospective study which tried to analyze the different causes of mortality in a tertiary care hospital in Mysore. In this study, mortality was higher in men than women. This observation is concordant with other similar studies and also with government mortality statistics.[1] Anatomic, lifestyle, behavioral, and socioeconomic differences between men and women may explain the observation. Majority of the deaths occurred in the age group of more than 50 years, with the highest mortality observed in the seventh decade. Similar observations were made by a study done in Madhya Pradesh.[2] This observation may be attributed to a high prevalence of noncommunicable diseases in this age group along with the burden of infections which can occur at any age.[3] Septicemia was the most common cause of mortality in our study. This observation was similar to the two previous studies; however, opposing observations were made by a study in Maharashtra.[4] The high prevalence of deaths due to septicemia may be due to the delay in seeking medical attention and indiscriminate use of self-medications, which include multiple antimicrobial agents which encourage bacterial drug resistance. In a developing nation such as India, there are multiple factors such as poverty, ignorance, overcrowding, and unhygienic living environment which also contribute to the high prevalence of septicemia.[5] A transsectoral approach that exploits all of the available potentials for prevention, early diagnosis, judicious and timely usage of appropriate antibiotics, and vaccinating persons in high-risk groups will help in decreasing sepsis-related mortality. Among noncommunicable diseases contributing to mortality in this study, highest mortality was due to cardiovascular diseases with highest contribution from ischemic heart disease. This can be attributed to the increasing prevalence of risk factors such as diabetes mellitus and hypertension, smoking, sedentary lifestyle, and obesity. Increasing trend in noncommunicable diseases was seen in Bhatia et al.[6] and Yang et al.[7] Road traffic accidents also contributed to a major proportion to mortality in this study. Strict implementation of simple traffic rules and transport norms can go a long way toward drastically reducing these deaths. Cerebrovascular accidents contributed to 11.3% of the total deaths. This can be attributed to the increased prevalence of risk factors for stroke such as hypertension and diabetes. Primary renal diseases and gastrointestinal causes were also contributed to the total mortality. Poisonings accounted for less number of deaths. Availability of centralized poison information center and treatment protocols result in better poison management practices in tertiary care hospitals by the clinicians. The majority of causes of death were based on clinical and ancillary investigations. Similar studies over the course of time would help in identifying the changing trends in causes of mortality.


  Conclusion Top


Although individual hospital data may not represent national health statistics, they provide useful indicators for the health status of a community. Causes of mortality are multifactorial. The most common cause of overall mortality in tertiary care hospital was sepsis followed by cardiac causes. Road traffic accidents also significantly contributed to the overall mortality. Steps are needed to be taken to educate the medical fraternity and the people about the prevalence and preventive strategies for communicable and noncommunicable diseases. Reorientation of the health delivery system and allocation of resources is required to enable the implementation of evidence-based strategies that can address this new challenge. This study will also be helpful for reviewing various reasons of mortality in the hospital, it would also be helpful for health managers to monitor mortality in various departments and plan for interventions to decrease the mortality.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Available from: http://www.censusindia.gov.in/vital_statistics/srs/Chap_4_-_2010.pdf. [Last accessed on 2017 Apr 09].  Back to cited text no. 1
    
2.
Khare N, Gupta G, Gupta SK, Khare S. Mortality trend in a tertiary care hospital of Bhopal, Madhya Pradesh. Ntl J Commun Med 2015;7:64-7.  Back to cited text no. 2
    
3.
Godale L, Mulaje S. Mortality trend and pattern in tertiary care hospital of solapur in Maharashtra. Indian J Community Med 2013;38:49-52.  Back to cited text no. 3
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4.
Joshi R, Cardona M, Iyengar S, Sukumar A, Raju CR, Raju KR, et al. Chronic diseases now a leading cause of death in rural India – Mortality data from the Andhra Pradesh rural health initiative. Int J Epidemiol 2006;35:1522-9.  Back to cited text no. 4
[PUBMED]    
5.
Arodiwe EB, Nwokediuko SC, Ike SO. Medical causes of death in a teaching hospital in South-Eastern Nigeria: A 16 year review. Niger J Clin Pract 2014;17:711-6.  Back to cited text no. 5
[PUBMED]  [Full text]  
6.
Bhatia S, Gupta A, Thakur J, Goel N, Swami H. Trends of cause-specific mortality in union territory of Chandigarh. Indian J Community Med 2008;33:60-2.  Back to cited text no. 6
[PUBMED]  [Full text]  
7.
Yang G, Kong L, Zhao W, Wan X, Zhai Y, Chen LC, et al. Emergence of chronic non-communicable diseases in China. Lancet 2008;372:1697-705.  Back to cited text no. 7
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