Causes Of Death At Autopsy In Hospitalized Adult Patients With Diabetes Mellitus: A Study From A Developing Country

Abstract

In order to determine the causes of death at autopsy in hospitalized adult diabetic patients at the University Hospital of the West Indies (UHWI), we reviewed the autopsy reports of consecutive autopsies performed over a 14-year period (1991 – 2004) in the Department of Pathology at the UHWI. Of the two thousand five hundred and forty-one adult autopsy reports retrieved, 400 (15.7%) represented patients with diabetes mellitus. The commonest cause of death was infection, followed by cardiovascular disease, which showed increasing frequency with time. Hyperglycaemic coma showed a significant decrease in frequency from the first seven-year period to the second. A reduction in mortality may possibly be accomplished through: patient education protocols that re-emphasise the importance of preventing injury and infection and the need for prompt solicitation of medical attention if infections occur; aggressive management of infections; and careful monitoring of cardiovascular function. Factors influencing the presence and severity of vascular disease require further investigation.