Mortality Patterns among Hospital Deaths.

Background Death occurring in hospital is medically certified by attending physicians with cause of death. In developing countries such as Nepal, limited resources are available related to the pattern of deaths that occur in hospitals, so that the health priorities can be selected wisely. Objective The objective of this study was to determine the pattern, frequency and causes of inpatient mortality in hospital. Method This was a retrospective study of all deaths occurred at the Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel from 1st January 2012 to 31st December 2013. There were 247 deaths and for each case, medical records were reviewed. Result There were 26,836 patients admitted during the study period and 247 (0.90%) of them died in hospital. Males accounted for 42.92% (n=106) deaths and female 57.08% (n=141). The average length of stay before death were less than 5 days (n=152). The majority of deaths were in Medicine department 52.64% (n=130) followed by Pediatrics 32.38% (n=80). Majority of deaths were at the extremes of life so that less than one month 12.95% (n=32) and over 60 years 36.84% (n=91). The main cause of death was respiratory disease 38.87% (n=96), followed by infectious 20.64% (n=51) and hepatobiliary disease 16.19% (n=40). Conclusion Registration data on causes for deaths occurring in hospitals require periodic validation prior to their use for epidemiological research or public health policy. Procedures for death certification and coding of underlying causes of death need to be streamlined to improve reliability of registration data. Estimation of cause-specific mortality from this research will inform the burden of disease and guide to intervene and reduce avoidable mortality in hospitals.