Causes of death in an urban public hospital.

For the study reported here, we examined the charts and autopsy reports of every death in the Department of Medicine at Cook County Hospital for the year 1983. In that period, there were 11,677 admissions to the Department and 476 deaths, yielding a mortality of 4.1 percent. There were 50 percent more deaths in the intensive care unit than on the general wards. Malignancies accounted for greater than one-third of all deaths. Lung cancer, which occurred in one of every six deaths in the department, was the single most-common diagnosis. The other leading causes of death were cirrhosis, gastrointestinal malignancies and cerebrovascular accidents. Cardiovascular mortality was somewhat less than expected. These figures reflect some of the serious diseases of the urban indigent population, which are, in turn, associated with cigarette smoking, alcoholism and hypertension. Decreases in morbidity and mortality are likely to be influenced by preventive medical measures and early detection campaigns. Department of medicine curricula and outpatient clinic programs should devote attention and resources to these areas.