Mortality In Tertiary Care Hospital Research Articles

Determinants of Poison-related Mortality in Tertiary Care Hospital, South India.

Acute poisoning is one of the most common emergencies in India and around the world. Understanding the factors associated with mortality can aid us in devising appropriate preventive strategies to curtail deaths due to poisoning. Purpose of this study is to find various factors that determine the mortality among acute poisoning cases admitted in a tertiary care center. A retrospective hospital records-based study was conducted at Chengalpattu Medical College Hospital. The study included 2,123 cases of various poisoning cases admitted for a year from January to December 2022. Cases of bites, stings, drowning, and hanging were excluded. Information on sociodemographic profile, type of poison, time since ingestion and admission, and treatment outcome were collected using a structured pro forma. The mean age of the study population was 29.90 ± 14.98 years. Poisoning was found to be predominantly among males (56.42%) and residents of rural areas (58%). Insecticide consumption (27.0%) was the most common modality, followed by oleander poisoning (20%), corrosive poison (17%), rat poison (15%), tablet poison (13%), and other poisons. The overall case fatality rate (CFR) was 5.2%, with the highest CFR of 12.25% with insecticide poisoning. In multivariate analysis, Glasgow coma scale (GCS) score at admission is the only parameter showing a statistically significant association with mortality (adjusted odds-ratio 0.271(0.2-0.38, p-value < 0.01). Acute poisoning primarily affects the young and economically productive population. In the south Indian population, pesticides are still the major contributor though corrosives are a major contributor among children. Mortality is still significant, and GCS status admission is the only predictor of mortality. Krishnasamy N, Narmadhalakshmi R, Parameshwari P, Jayalakshmi R, Lokesh R, Jayanthi R, et al. Determinants of Poison-related Mortality in Tertiary Care Hospital, South India. Indian J Crit Care Med 2024;28(4):329-335.

Co-Morbidities associated with hypomagnesemia and affecting in-hospital mortality in tertiary care hospital of Sindh Pakistan-2021

Background: Hypomagnesemia may cause severe and fatal complications if not timely diagnosed and properly treated, and associated with increased In-Hospital Mortality. Methods: A case-control study was conducted. The case definition was any patient of any age and sex having hypomagnesemia and admitted to ICU. The controls were taken in 1;2. We defined Hypomagnesemia with less than 1.46mg/dl level of magnesium and In-Hospitals mortality as the primary endpoint. Demographic, risk factor data were taken and analyzed using EPI INFO TM 7. The association was calculated using Odds Ratios and reported at 95% CI and P value less than 0.05. Results: Of 139 patients, 42 were cases. The average age was 53 years (14 to 85 Years ±16 years). Males were 72 (49%) and 78 (66%) participants were from rural setup. Diabetes mellitus was found in 33 (78%) of cases and 44 (46%) in controls, hypertension in 36 (85%) of cases and 41 (42%) of controls, dyslipidemia in 20 (48%) of cases and 37 (38%) of controls, obesity in 26 (62%) of cases and 37 (38%) of control, and anaemia in 28 (67%) of cases and 41 (42%) of control.

Trends in Maternal Mortality in Tertiary Care Hospital, Peshawar Pakistan- A Follow up study

Objective: To describe the trends in maternal mortality in tertiary care hospitals in the last five years and compare the mortalities in the previous ten years. Methods: All pregnant women from January 2016 to December 2020 were analyzed. The primary outcome of this research was maternal mortality ratios. Various causes of maternal mortality were also evaluated. The correlation between maternal characteristics and maternal mortality was inspected using logistic regression models. Pregnancy outcomes of mothers who died versus mothers who survived were also evaluated. Results: One hundred seventy-three maternal deaths were noted in 49283 pregnant women in 2016-2020. The average maternal mortality ratio in 5 years period was 409 per 100,000 live births. It showed a decreasing curve over the five years, from 539/100,000 live births in 2016 to 295 in 2020. Five year clusters also demonstrated a falling trend, from 856/100,000 live births to 409. Hemorrhage (34.68%), hypertensive disorders of pregnancy (21.38%), suspected cases of thromboembolism (20.80%) were the leading causes of maternal mortality. Pregnancy outcomes in mothers who survived and who expired were evaluated. Almost 33% of maternal deaths had stillbirths as compared to 4.69% in alive mothers (RR 6.87); similarly, unknown outcomes (RR7.56) and ectopic pregnancies (RR 3.01) were more frequent in cases of maternal demise. Conclusion: Trends in maternal mortality show a decreasing curve. Hemorrhage remains the leading cause. Attainment of SDGs requires interventions both at primary and tertiary health care. Keywords: Maternal mortality and Maternal Mortality Ratio (MMR), trends, causes of maternal mortality.

Prepare and prevent rather than repair and repent: Study of maternal mortality in tertiary care hospital

Context: Maternal death signifies the quality of healthcare provided in the population. It is the young, relatively healthy women who die of various reasons. Audit of such mortality would prevent the recurrence by taking appropriate measures. Aims: To find the causes of maternal mortality. Settings and Design: Retrospective observational study. Materials and Methods : All maternal deaths in a tertiary care referral center from January 2007 to September 2012 were studied for their demographic profile and causes of death. Results: All 62 women were referred from other healthcare units. Twenty-nine patients died within 24 h of admission and 33 women died after 24 h of admission. Death of 34 patients was due to direct obstetric causes and of 26 patients due to indirect obstetric causes. There were 2 maternal deaths due to accidental causes. Conclusions: The corrective action to prevent the recurrence of such deaths should be taken. Sepsis was found to be the commonest cause for maternal mortality followed by hemorrhage. It important to note that, in the present study, all mothers received antenatal care, had hospital delivery (none had home delivery), no teenage pregnancy or grand multigravidas, and no obstructed labor or rupture uterus, and yet they died. There is a change in the trend of causes of maternal mortality. Strengthening of the first referral units with equipment, blood bank, and adequately competent staff should be of prime importance. Continued medical education of the medial personnel at the periphery is required. Maternal deaths occur in inspite of atenatal care and hospital delivery which is alarming. Contributing factors may be delay in referral or the travel which should be looked in to inorder to minimize such death of young women.