Potentially Preventable Deaths by Intensive Care Medicine in Mongolian Hospitals.

Naranpurev Mendsaikhan,Ganbold Lundeg,Tsolmon Begzjav,Martin W Dünser

doi:10.1155/2016/8624035

Abstract

Purpose. To evaluate the portion of hospitalized patients dying without prior intensive care unit (ICU) admission and assess whether death could have been prevented by intensive care. Methods. In this prospective, observational, multicenter study, data of adults dying in and outside the ICU in 5 tertiary and 14 secondary hospitals were collected during six months. A group of experts categorized patients dying without prior ICU admission as whether their death was potentially preventable or not. Results. 617 patients died (72.9% in and 27.1% outside the ICU) during the observation period. In 54/113 patients (32.3%) dying in the hospital without prior ICU admission, death was considered potentially preventable. The highest number of these deaths was seen in patients aged 16–30 years and those who suffered from an infection (83.3%), underwent surgery (58.3%), or sustained trauma (52%). Potentially preventable deaths resulted in a total number of 1,078 years of life lost and 709 productive years of life lost. Conclusions. Twenty-seven percent of adults dying in Mongolian secondary and tertiary level hospitals do so without prior ICU admission. One-third, mostly young patients suffering from acute reversible conditions, may have potentially been saved by intensive care medicine.

Highlights

Mongolia is a Central Asian landlocked country which is home to approximately three million people [1]
We evaluated the portion of patients who died in Mongolian hospitals without prior admission to the intensive care unit (ICU) and, based on these data, estimated the number of deaths which could have potentially been prevented by intensive care
Autopsies were performed less frequently in patients dying without prior ICU admission than in those who died in the ICU

Summary

Introduction

Mongolia is a Central Asian landlocked country which is home to approximately three million people [1]. In a recent nationwide survey, our study group observed that the adult and pediatric ICU bed capacity in Mongolia [11.7 intensive care unit (ICU) beds per 100,000 inhabitants] compares favorably with other low- and middleincome countries. Critical illness in Mongolia affects younger patients compared to high-income countries. ICU admission diagnoses are similar with a high incidence of stroke and liver failure. ICU mortality is approximately 25% with most deaths caused by stroke, liver failure, and traumatic brain injury (unpublished results). It is currently unknown whether critically ill patients in Mongolia are routinely referred to the ICU service or remain in non-ICU wards for treatment

Methods

Results

Conclusion