Mortality pattern in a trust hospital: a hospital based study in Karachi

Objectives: To determine the frequency and causes of inpatient mortality in a trust hospital in a lower middle class community of Karachi. Methods: The retrospective analysis was conducted with the audit records of patients who died at the Chiniot General Hospital, Karachi, during five calendar years, from 2006 to 2010. SPSS 11 was used for statistical analysis. Results: There were 36446 admissions during the study period and 584 (1.6%) of them died in hospital. Males accounted for 54% (n=316) deaths, while the collective mean and median age was 37.9±20.6 years and 45 years respectively. The average length of stay was 4±3.8 days (median 2 days). Mortality increased slightly from 1.4% to 1.9% during the first four years, but decreased in 2010. The majority of deaths were in Medicine (n=348; 3.5%) followed by paediatrics (n=195; 2.2%). Mortality in Surgery (n=35; 0.06%) and Obstetrics was (n=6; 0.05%). Majority of deaths were in extremes of life: less than one year (n=177; 30.2%) and over 60 (n=216; 37%). The primary cause of death was infections 161 (27.6%), followed by respiratory disorders 126 (21.6%), and cardiovascular 81 (13.9%). Conclusions: Infections leading to septicaemia and pneumonia were the leading causes of hospital mortality in the study setting, followed by cardiovascular causes. Priorities and strategies for improving the standards of care should be defined.