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Intern Med J. 2001 Aug;31(6):343-8.

Antecedents to hospital deaths.

Author information

1
University of New South Wales, Liverpool Hospital, Australia. k.hillman@unsw.edu.au

Abstract

BACKGROUND:

Recent studies have suggested there are a large number of potentially preventable deaths in Australian hospitals.

AIM:

This study aimed to document antecedent factors in hospital deaths in an attempt to identify potentially preventative factors.

METHODS:

The study was conducted at three separate acute hospitals. Demographics of all deaths were recorded over a 6-month period as well as antecedent factors present within 0-8 and 8-48 h of all deaths including vital sign abnormalities, cardiorespiratory arrests and admission to intensive care. Separate analysis was performed on 'not for resuscitation' deaths.

RESULTS:

There were a total of 778 deaths, of which 549 (71%) were 'not for resuscitation'. There were 171 (22%) deaths preceded by arrest and 160 (21%) preceded by admission to intensive care. Of the remaining deaths, 30% had severely abnormal physiological abnormalities documented. This incidence was 50% in the non-do not resuscitate (DNR) subgroup. Concern about the patient's condition was expressed in the patient's notes by attending nursing staff and junior medical staff in approximately one-third of non-DNR deaths. Hypotension (30%) and tachypnoea (17%) were the most common antecedents in the non-DNR deaths.

CONCLUSION:

There is a high incidence of serious vital sign abnormalities in the period before potentially preventable hospital deaths. These antecedents may identify patients who would benefit from earlier intervention.

[Indexed for MEDLINE]

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