Antecedents to hospital deaths
Source: Internal Medicine Journal, Volume 31, Number 6, August 2001 , pp. 343-348(6)
Background: Recent studies have suggested there are a large number of potentially preventable deaths in Australian hospitals.
Aim: This study aimed to document antecedent factors in hospital deaths in an attempt to identify potentially preventative factors.
Methods: The study was conducted at three separate acute hospitals. Demographics of all deaths were recorded over a 6-month period as well as antecedent factors present within 0–8 and 8–48 h of all deaths including vital sign abnormalities, cardiorespiratory arrests and admission to intensive care. Separate analysis was performed on ‘not for resuscitation’ deaths.
Results: There were a total of 778 deaths, of which 549 (71%) were ‘not for resuscitation’. There were 171 (22%) deaths preceded by arrest and 160 (21%) preceded by admission to intensive care. Of the remaining deaths, 30% had severely abnormal physiological abnormalities documented. This incidence was 50% in the non-do not resuscitate (DNR) subgroup. Concern about the patient’s condition was expressed in the patient’s notes by attending nursing staff and junior medical staff in approximately one-third of non-DNR deaths. Hypotension (30%) and tachypnoea (17%) were the most common antecedents in the non-DNR deaths.
Conclusion: There is a high incidence of serious vital sign abnormalities in the period before potentially preventable hospital deaths. These antecedents may identify patients who would benefit from earlier intervention. (Intern Med J 2001; 31: 343–348)
Document Type: Research Article
Affiliations: 1: University of New South Wales 2: Department of Intensive Care, Liverpool Hospital 3: Epidemiology Unit, South Western Sydney Area Health Service 4: Department of Intensive Care, St George Hospital, Sydney 5: Department of Intensive Care, Illawarra Regional Hospital, Wollongong, New South Wales, Australia
Publication date: August 1, 2001