Mortality Analysis During July & September 2022 At Benazir Bhutto Hospital Rawalpindi: Mortality Analysis at Benazir Bhutto Hospital Rawalpindi

Rizwana  Shahid; Sadia  Khan; Rabbia  Khalid; Muhammad  Umar; Shaikh  Abdul Rehman; Nargis Zaidi

doi:10.54393/pjhs.v3i07.383

Authors

Rizwana Shahid Department of Community Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan
Sadia Khan Department of Family Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan
Rabbia Khalid Department of Pathology, Rawalpindi Medical University, Rawalpindi, Pakistan
Muhammad Umar Department of Gastroenterology, Rawalpindi Medical University, Rawalpindi, Pakistan
Shaikh Abdul Rehman Department of Community Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan
Nargis Zaidi Department of Community Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v3i07.383

Keywords:

In-Hospital Mortality, Infants, Neonates, Sepsis, Low Birth Weight

Abstract

Hospital mortality reflects the quality of healthcare and is a tool to perceive department-wise variations in health care services. Objectives: To determine age, gender and department-wise mortality reported during July and September 2022 at Benazir Bhutto Hospital Rawalpindi. Methods: A cross-sectional descriptive study was done to analyse the variations in age, sex and department-wise in-hospital mortality among reported deaths at Benazir Bhutto Hospital (BBH) Rawalpindi during July and September 2022. The data were gathered from Hospital administration through informed consent. The demographics and primary cause of mortality were scrutinized. Data were analysed by using SPSS version 25.0 and Microsoft Excel 2010. Hospital death rate during July and September 2022 were computed. Difference in mean age of the expired cases other than those of infant and neonates was statistically determined by independent sample t-test. P < 0.05 was considered significant. Results: Of the total 5338 and 4514 patients admitted at BBH during July and September 2022, about 8.2% and 7.1% deaths were reported respectively. On an average 53.2% males and 46.8% females succumbed to various diseases. About 58.5% and 64.2% deaths were reported from Paediatrics department during July and September 2022 respectively. Around 45.6% neonatal deaths were reported during two months’ period. Difference in mean age of expired cases excluding infants and neonates was statistically insignificant (P=0.09). Infants and neonates frequently succumbed to sepsis, low birth weight, birth asphyxia and pneumonia. Conclusion: Infants and neonates are more susceptible to in-hospital mortality predominantly due to sepsis and low birth weight.

References

Phillips DE, Lozano R, Naghavi M, Atkinson C, Gonzalez-Medina D, Mikkelsen l, et al. A composite metric for assessing data on mortality and causes of death: the vital statistics performance index. Population health metrics. 2014 Dec; 12(14): 1-16. doi: 10.1186/1478-7954-12-14.

Arora L and Ikbal F. Experiences of implementing Hospital Management Information System (HMIS) in at a tertiary care hospital, India. Vilakshan - XIMB Journal of Management 2021 Nov; 1-23. doi: 10.1108/XJM-09-2020-0111.

English M, Mwaniki P, Julius T, Chepkirui M, Gathara D, Ouma PO, et al. Hospital mortality: A neglected but rich source of information supporting the transition to higher quality health systems in low and middle-income countries. BMC Medicine 2018 Dec; 16(1): 1-9. doi: 10.1186%2Fs12916-018-1024-8.

World Health Organization. Targets of Sustainable Development Goal 3. [Last cited on: 28th January 2022]. Available at: https: //www.who.int/europe/about-us/our-work/sustainable-development-goals/targets-of-sustainable-development-goal-3.

World Health Organization. The Global Health Observatory. [Last cited on: 28th January 2022]. Available at: https: //www.who.int/data/gho/data/countries/country details/GHO/pakistan?countryProfileId=314d19a1-bfdc-4611-a586-54cd8aec3531.

Barber RM, Fullman N, Sorensen RJ, Bollyky T, McKee M, Nolte E, et al. Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990–2015: a novel analysis from the Global Burden of Disease Study 2015. The lancet. 2017 Jul; 390(10091): 231-66. doi: 10.1016/s0140-6736(17)30818-8.

Setel PW, Macfarlane SB, Szreter S, Mikkelsen L, Jha P, Stout S, et al. A scandal of invisibility: making everyone count by counting everyone. The Lancet. 2007 Nov; 370(9598): 1569–77. doi: 10.1016/s0140-6736(07)61307-5.

Choi J, Ki M, Kwon HJ, Park B, Bae S, Oh CM, Chun BC, Oh GJ, Lee YH, Lee TY, Cheong HK. Health indicators related to disease, death, and reproduction. Journal of Preventive Medicine and Public Health. 2019 Jan; 52(1): 14-20. doi: 10.3961/jpmph.18.250.

Kobewka DM, van Walraven C, Turnbull J, Worthington J, Calder L, Forster A. Quality gaps identified through mortality review. BMJ quality & safety. 2017 Feb; 26(2): 141-9. doi: 10.1136/bmjqs-2015-004735.

Zakaria A, Piper M, Douda L, Jackson NM, Flynn JC, Misra DP, et al. Determinants of all-cause in-hospital mortality among patients who presented with COVID-19 to a community teaching hospital in Michigan. Heliyon 2021 Dec; 7(12): e08566. doi: 10.1016%2Fj.heliyon.2021.e08566.

Pitocco C, Sexton TR. Measuring hospital performance using mortality rates: an alternative to the RAMR. International Journal of Health Policy and Management. 2018 Apr; 7(4): 308-16. doi: 10.15171%2Fijhpm.2017.94.

Schwartz N, Sakhnini A, Bisharat N. Predictive modeling of inpatient mortality in departments of internal medicine. Internal and Emergency Medicine. 2018 Mar; 13(2): 205-11. doi: 10.1007/s11739-017-1784-8.

Shahid R, Umar M, Zeb S, Khokhar MN, Zafar F, Fatima F. Mortality review in tertiary healthcare facilities of Rawalpindi from 1st March-10th April 2022. Journal of Community Medicine and Public Health Reports 2022. Jun; 3(07): 1-5. doi: 10.38207/JCMPHR/2022/JUL03070453.

UNICEF. Neonatal mortality. Last Update December 2021. Available at: https: //data.unicef.org/topic/child-survival/neonatal-mortality/.

Houweling TA, Kunst AE, Borsboom G, Mackenbach JP. Mortality inequalities in times of economic growth: time trends in socioeconomic and regional inequalities in under 5 mortality in Indonesia, 1982–97. Journal of Epidemiology & Community Health. 2006 Jan; 60(1): 62-8. doi: 10.1136/jech.2005.036079.

Amouzou A, Jiwani SS, da Silva ICM, Carvajal-Aguirre L, Maiga A, Vaz LME, et al. Closing the inequality gaps in reproductive, maternal, newborn and child health coverage: slow and fast progressors. BMJ Global Health 2020 Jan; 5: e002230. doi: 10.1136/bmjgh-2019-002230.

Moss W, Darmstadt GL, Marsh DR, Black RE, Santosham M. Research priorities for the reduction of perinatal and neonatal morbidity and mortality in developing country communities. Journal of perinatology. 2002 Sep; 22(6): 484-95. doi: 10.1038/sj.jp.7210743.

Dawood Z, Majeed N. Assessing neo-natal mortality trends in Pakistan: an insight using equity lens. Archives of Public Health. 2022 Dec; 80(1): 1-10. doi: 10.1186/s13690-021-00767-1.

World Health Organization. New born mortality. [Last cited on: 28th January 2022]. Available at: https: //www.who.int/news-room/fact-sheets/detail/levels-and-trends-in-child-mortality-report-2021

Andegiorgish AK, Andemariam M, Temesghen S, Ogbai L, Ogbe Z, Zeng L. Neonatal mortality and associated factors in the specialized neonatal care unit Asmara, Eritrea. BMC Public Health 2020 Dec; 20(10): 1-9. doi: 10.1186/s12889-019-8118-x.

Chowdhury HR, Thompson S, Ali M, Alam N, Yunus M, Streatfield PK. Causes of neonatal deaths in a rural subdistrict of Bangladesh: implications for intervention. Journal of health, population, and nutrition. 2010 Aug; 28(4): 375. doi: 10.3329%2Fjhpn.v28i4.6044.

Perin J, Mulick A, Yeung D, Villavicencio F, Lopez G, Strong KL, et al. Global, regional and national causes of under-5 mortality in 2000-19: An updated systematic analysis with implications for the Sustainable Development Goals. The Lancet Child & Adolescent Health 2022 Feb; 6(2): 106-15. doi: 10.1016/S2352-4642(21)00311-4.

UNICEF. Under-Five mortality. [Last cited on: December 2021]. Available at: https: //data.unicef.org/topic/child-survival/under-five-mortality/.

Gutema GD, Geremew A, Mengistu DA, Dammu YM, Bayu K. Trends and Associated Factors of Under-five Mortality Based on 2008–2016 Data in Kersa Health and Demographic Surveillance Site, Eastern Ethiopia. INQUIRY: The Journal of Health Care Organization, Provision, and Financing. 2022 Mar; 59: 1-12. doi: 10.1177%2F00469580221090394.

Fabijanic D, Culic V, Bozic I, Miric D, Stipic SS, Radic M, et al. Gender differences in in-hospital mortality and mechanisms of death after the first acute myocardial infarction. Annals of Saudi medicine. 2006 Nov; 26(6): 455-60. doi: 10.5144%2F0256-4947.2006.455.

Chen FT, Chou AH, Chan Y, Wu VCC, Lin CP, Hung KC, et al. Sex-related differences on the risks of in-hospital and late outcomes after acute aortic dissection: A nationwide population-based cohort study. PLoS ONE 2022 Feb; 17(2): 1-13. doi: 10.1371/journal.pone.0263717.

Wright J, Dugdale B, Hammond I, Jarman B, Neary M, Newton D, et al. Learning from death: a hospital mortality reduction programme. Journal of the Royal Society of Medicine. 2006 Jun; 99(6): 303-8. doi: 10.1258%2Fjrsm.99.6.303.