Department of Medicine, Aga Khan University Medical College, Stadium Road, Karachi 74800, Pakistan.
Postgrad Med J. 2009 Sep;85(1007):470-4. doi: 10.1136/pgmj.2008.074898.
To acquire systematic data on the causes of hospital mortality in Pakistan, a developing country with scant mortality records.
Retrospective review of death certificates and hospital charts of patients dying on general and specialty medical services at our hospital during one calendar year.
Of a total 10,590 admissions, 657 (6.2%) died in hospital. The deceased included 357 (54.4%) males and 299 (45.6%) females, with a collective median age of 63 years and mean length of stay 6.71 days (median 4 days, range 1-56 days). Primary cause of death was categorised as infectious (21.2%), pulmonary (17.2%), cancer related (15.7%), cardiovascular (12.6%), gastrointestinal and hepatic (10.8%), neurological (11.4%) and miscellaneous (11.1%). Within each category, the most common diagnoses were septicaemia (76.9% of infectious cases), pneumonia (55.7% of pulmonary cases), myocardial infarction (40.9% of cardiovascular), intracranial haemorrhage (37.3% of neurological), and cirrhosis (45.0% of gastrointestinal). There were multiple causes among malignant disorders with no single cause dominating. Patients with cardiovascular and pulmonary deaths tended to be older than the median age (p = 0.001), while patients with gastrointestinal and cancer related deaths tended to be younger than the median age (p = 0.001). Length of stay did not differ significantly among the various subgroups. About a quarter (26.4%) deaths occurred within 24 h of admission.
Infections, including septicaemia and pneumonia, are the leading causes of hospital mortality in our setting, followed by malignancy and cardiovascular causes. The overall mortality rate is comparable to published mortality data from other hospital settings.
获取系统数据，了解巴基斯坦（一个死亡率记录匮乏的发展中国家）医院死亡率的原因。
回顾性分析我院一年内在普通和专科医疗服务中死亡的患者的死亡证明和病历。
在总共 10590 例住院患者中，有 657 例（6.2%）在院死亡。死亡患者中包括 357 例（54.4%）男性和 299 例（45.6%）女性，平均年龄为 63 岁，平均住院时间为 6.71 天（中位数 4 天，范围 1-56 天）。主要死亡原因分为感染性（21.2%）、肺部（17.2%）、癌症相关（15.7%）、心血管（12.6%）、胃肠道和肝脏（10.8%）、神经（11.4%）和其他（11.1%）。在每个类别中，最常见的诊断是败血症（感染病例的 76.9%）、肺炎（肺部病例的 55.7%）、心肌梗死（心血管病例的 40.9%）、颅内出血（神经病例的 37.3%）和肝硬化（胃肠道病例的 45.0%）。恶性疾病有多种病因，没有单一病因占主导地位。心血管和肺部死亡患者的年龄比中位数大（p=0.001），而胃肠道和癌症相关死亡患者的年龄比中位数小（p=0.001）。不同亚组之间的住院时间无显著差异。约四分之一（26.4%）的死亡发生在入院后 24 小时内。
在我们的研究环境中，感染（包括败血症和肺炎）是医院死亡率的主要原因，其次是恶性肿瘤和心血管疾病。总的死亡率与其他医院环境的公布死亡率数据相当。
