Abstract
Objective: To determine the mortality rate in the ophthalmic ward at the Sekuru KaguviHospital Eye Unit (SKHEU), Zimbabwe, from January 2009 to December 2013 and to identify the causes of death.Design: A hospital-based clinical audit.Methods: Data from completed hospital death notification forms and medical records of patients who had died in the ward during the review period were collected that included age, gender, diagnoses, date of admission, date of death and cause of death. The data were analysed using Epi Info7 software.Setting: The audit was conducted at SKHEU, the largest tertiary eye unit in Zimbabwe. It comprises an ophthalmic ward with 30 beds and caters for about 900 patients per year. Patients are admitted via the Out-patients Department where about 30 000 patients are seen yearly. SKHEU is part of the Parirenyatwa Group of Hospitals, which is one of the four major referral hospitals in Zimbabwe.Results: Of the 4722 ophthalmic admissions at SKHEU during the 5-year study period, therewere 15 (0.3%) deaths, with a male:female ratio of 3:2 giving a mortality rate of 0.3% and an average of 3 deaths per year. The highest number of deaths was in 2009 when 7 deaths occurred, whilst the lowest number was 1 death in 2010 and 1 in 2013. Of the 15 deaths,4 (26.7%) were children < 12 years old and 11 (73.3%) were adults; of whom 12 (80%) patients had orbital malignancies, 2 (13.3%) had orbital cellulitis and 1 (6.7%) had ocular trauma. Theorbital malignancies included ocular surface squamous neoplasia (OSSN), retinoblastomaand non-Hodgkins lymphoma (NHL). The most common probable cause of death was OSSN which accounted for 9 (60%) of the deaths.Conclusion: The mortality rate at SKHEU was 0.3%, with approximately 3 deaths occurring per year. The most common attributable cause of death was OSSN.
Highlights
IntroductionMortalities arising from pathologies of the eye are relatively uncommon compared with other medical specialties.[1,2] In a resource-constrained low- and medium-income setting, ophthalmic mortality rates are higher and often attributable to avoidable and potentially treatable causes such as severe infections and orbito-ocular malignancies.[1,2,3,4,5,6] In contrast, in developed economies where facilities are available and access barriers to optimal eye care have been largely overcome, the rates are lower and mainly owing to unavoidable causes.[2,7,8] The mortality rate of a health institution may be an indicator of its performance or a representation of the burden of fatal conditions that the institution is faced with.[9]
The mortality rate of 0.3% observed in the ophthalmic ward at Sekuru Kaguvi Hospital Eye Unit (SKHEU) over the period 2009–2013 is similar to that reported at the same institution from 1984 to 2008 by Masanganise et al.[10] and has remained constant over the past 30 years
The mortality rate in the ophthalmic ward at SKHEU was 0.3%, with an average of 3 deaths occurring per year, and http://www.avehjournal.org the leading attributable cause of death was ocular surface squamous neoplasia (OSSN)
Summary
Mortalities arising from pathologies of the eye are relatively uncommon compared with other medical specialties.[1,2] In a resource-constrained low- and medium-income setting, ophthalmic mortality rates are higher and often attributable to avoidable and potentially treatable causes such as severe infections and orbito-ocular malignancies.[1,2,3,4,5,6] In contrast, in developed economies where facilities are available and access barriers to optimal eye care have been largely overcome, the rates are lower and mainly owing to unavoidable causes.[2,7,8] The mortality rate of a health institution may be an indicator of its performance or a representation of the burden of fatal conditions that the institution is faced with.[9]. The objectives of the present study were to determine the mortality rate in the ophthalmic ward at the Sekuru Kaguvi Hospital Eye Unit (SKHEU), identify the possible causes of death and suggest interventions for reducing mortality in the eye ward
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