Epidemiology of in‐hospital mortality in acute patients admitted to a tertiary‐level hospital

Abstract

Acute in-patient mortality is unequally distributed throughout the hospital, and a small number of diagnoses has large associated in-patient mortality rates. Repeated involvement of the RRT is associated with in-patient mortality.

Resuscitation orders in acute hospitals: A point prevalence study

“…Our data show the significant proportion of MET call work is writing DNR orders and this is consistent with existing literature. The patients for whom the MET write or recommend limitations of medical treatment are more likely to die in hospital within 24 hours of the MET instituted DNR . Primary care clinicians are reluctant to initiate DNR orders but will agree with the MET initiation of DNR orders .…”

End-of-life care and intensive care unit clinician involvement in a private acute care hospital: A retrospective descriptive medical record audit

“…An ICU clinician was involved in the care of 66% of patients who died in 2017 within the site investigated, either through ICU admission (36%) or contact with the ICU outreach team only (30%), a finding similar to other Australian studies. 4,20 Baseline differences between cohorts such as the younger age of the ICU Admission cohort, lower incidence of dementia, and higher likelihood of a primary surgical admission and having been transferred from another acute care facility suggest that this cohort may have had more acute reversible disease. These characteristics may also be associated with a better baseline prognosis and hence a greater likelihood that an acute interventional approach would be taken.…”

“…3 Evidence from two recent Australian studies suggests that 12e30% of people who die in an acute hospital setting had received care in an intensive care unit (ICU). 2,4 Although ICU clinicians provide expert care to those admitted to the ICU, their expertise is also applied beyond the ICU in Code Blue or Medical Emergency Teams (METs). 4,5 Furthermore, at least 30% of MET reviews involve elements of EOL care.…”

“…2,4 Although ICU clinicians provide expert care to those admitted to the ICU, their expertise is also applied beyond the ICU in Code Blue or Medical Emergency Teams (METs). 4,5 Furthermore, at least 30% of MET reviews involve elements of EOL care. 5 Given that the involvement of ICU clinicians in EOL care is multifaceted, 6 the Australian Commission on Safety and Quality in Health Care (ACSQHC) 7 recommends the examination of ICU clinician involvement as part of any evaluation of EOL care in acute hospitals.…”

Respiratory Compromise as a New Paradigm for the Care of Vulnerable Hospitalized Patients

“…Patients admitted to hospitals with preexisting respiratory conditions have relatively high mortality rates. 12,13 Patients admitted with acute pneumonia have significant mortality rates, 14,15 and those admitted with aspiration have even higher rates of death. 16 Death may not be due directly to the lung infection, since Ͼ1 in 4 patients with community-acquired pneumonia develop heart failure, arrhythmias, or myocardial infarction.…”