An analysis of the internal medicine inpatient mortality profile in Mankweng Hospital

Abstract

Background: Departmental analysis of causes of death assists in defining hospital health policy priorities. They are important in rural tertiary hospitals like Mankweng. Aim: The aim of the study was to analyse the causes of death in inpatients over 12 years in the Internal Medicine Department in Mankweng Hospital, Limpopo Province, South Africa, from the 1st of June 2019 to the 1st of November 2019. Methods: This was a five-month (1st June 2019 to 1st November 2019) retrospective descriptive study with an analysis of the inpatients’ mortality profile in Mankweng Hospital with emphasis on all deaths that occurred in the Internal Medicine wards (census sampling). A questionnaire was designed and used to collect data from 228 deceased files. The main causes of death by age group were determined. The effects of factors such as the ‘weekend effect’, deaths within 48 hours of admission, and the proportion of HIV/AIDS on deaths, which have been identified globally as affecting inpatient mortality rates, were also determined in this study. The collected data was analysed using Excel spreadsheets. Results: A total of 228 medical records of deceased inpatients constituted the study population. The median age was 56 (14-103) years and 51.3% of females died. Communicable diseases accounted for 56.1% and non-communicable-related deaths constituted 43.9%. Leading causes of death were pneumonia (30.5%) and cancer (33%) with more (58) males dying from pneumonia and TB. Age was observed as significant determinant of death. More than 90% of patients knew their HIV status, close to half (46.9%) were HIV positive, 72% had a CD4 count < 200 cells/mm3 with only 25.2 percent on ARVs. At least 120 (52.6%) of participants had comorbidities. Conclusion: The mortality of Internal Medicine inpatients at Mankweng Hospital demonstrates a dual burden of communicable and non-communicable diseases, as well as an increase in the number of participants above 60 years dying within 48 hours of admission and no ‘weekend effect’. This challenges national and provincial health system