In-hospital mortality due to infectious disease in an Internal Medicine Department. Epidemiology and risk factors.

OBJECTIVE

Hospital mortality is a leading indicator of quality of healthcare and a valuable tool for planning and management. Infectious diseases represent a substantial part of the activity of internal medicine.Our aim was to describe the characteristics of in-hospital mortality due to infectious diseases and associated risk factors in our environment.

MATERIALS AND METHODS

A retrospective case-control study was designed. We reviewed deaths during 2012 from an Internal Medicine Department. 187 cases (infectious disease related mortality) and 224 controls were found. Clinical and demographic information was obtained from medical records. Comorbidity was evaluated with Charlson index (CI). Data were analyzed using SPSS 15.0 (p-value < 0.05).

RESULTS

During 2012, of the 3193 discharge, 187 were exitus due to infectious disease (5.8%). Mean age was 85.7 ± 7.6, higher in women (88 ± 7 vs 83 ± 7.4, p < 0.001), and 55% were aged over 85 years. The CI mean was 4.2 ± 3, higher in younger than 85 years (5.3 ± 3.4 vs 3.6 ± 2.6, p < 0.001). Most frequent causes of death were respiratory sepsis (29%), severe pneumonia (23.5%) and urinary sepsis (16.6%) and risk factors were living in Nursing Home (55.6% vs 34%, p < 0.001), being dependent (73.8% vs. 44.6%, p < 0.001), dementia (59.4% vs 27.2%, p < 0.001) and cerebrovascular disease (25.7% vs 17.4%, p = 0.041).

CONCLUSIONS

Dementia, cerebrovascular disease, living in Nursing Home and being dependent were risk factors for infectious disease in-hospital mortality in our study, but not comorbidity, age or length of stay. Our series, although limited by retrospective design, is the first qualitative study of in-hospital mortality due to infectious disease in an Internal Medicine Service in our environment. Most frequent cause of death in our setting was respiratory etiology.