An audit of indoor morbidity and mortality in a medical ward at a Tertiary Care Hospital

Abstract

There is a great geographical variation in disease burden around the world, which is due primarily to environmental, genetic, social and economic factors. Similar variations exist in worldwide mortality figures from a particular disease that can be attributed almost entirely to the access and efficacy of healthcare facilities. We did this audit to identify the major causes of morbidity and mortality in patients admitted in a medical unit of a tertiary care hospital and to highlight the importance of primary prevention. The audit was carried out in West Medical Ward Mayo Hospital Lahore, Pakistan from 1st January 2004 to 31st December 2004. All patients admitted with medical problems from the Outpatient and Emergency Departments were included. During the year 2004, a total of 2045 patients were admitted, out of which maximum number of patients admitted in the ward were suffering from chronic liver disease (17%) followed by ischemic heart disease (14.4%) cerebrovascular accidents (10.4%) and renal diseases. Total number of deaths were 321 with male mortality was 167 (14.40%) and female mortality 154 (17.40%). Chronic liver disease also had the highest mortality (16.8%) followed by cerebrovascular accidents (14%), renal disease (11.5%) and ischemic heart disease (7.8%). Even the mortality due to chronic liver disease was significantly higher (p <0.01) than ischernic heart disease. The number of patients having the four common diseases having age 45 years or more (770) was significantly greater (p <0.0001) then the number of patients (279) in the age range of 15 to 44 years. It was observed that significantly greater number of male patients (595) had morbidity than females (462), (p <0.0001), while mortality has no difference. Chronic liver disease, ischemic heart disease and cerebrovascular accidents are the diseases putting maximum burden on our health resources and disabling our productive population. This audit highlights the fact that all these three groups of diseases can be prevented and thus obviates the need of primary prevention of these major killers.