Contribution of respiratory disease and smoking to in-hospital mortality
Neeraj Shah1, Dean Jansen2 and Louise Restrick2
Introduction: Mortality reduction strategies are informed by death certificates (DC). The aim of this study was to determine the contribution of respiratory disease and smoking to in-hospital deaths as recorded on DCs.
Methods: A retrospective analysis of all adult deaths (excluding those examined by the Coroner) at a inner-city hospital (April 2013-March 2014). Data was obtained from DCs and electronic records.
Conclusions: Half of in-patient deaths were due to a respiratory disease, the majority as pneumonia. However, no underlying cause of pneumonia was recorded in more than half. Where recorded, non-respiratory causes of pneumonia were three times more common than respiratory causes. A smoking-attributable cause of death was documented for 72% patients but smoking history was only recorded for 9%. These data make the case for increased clinician leadership in training/supervision of death certification focusing on documentation of the underlying diseases resulting in pneumonia and recording where smoking is a contributing cause of death.
PDPI Sumatera Utara. 19/03/18.
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