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Research & Reviews: Journal of Medical and Health Sciences

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ISSN: 2319-9865

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Study of Mortality Pattern in Adults at a Tertiary Care Teaching Hospital in South India

Mohamed Murtuza Kauser1*, Someshwar Kinnera2, Jonathan Korrapolu2, Sasidhar Naga Kalyanam1, Kalavathi G Parameshwarappa1, Asfia Afreen3
  1. Department of Medicine, Basaveshwara Medical College and Hospital, Chitradurga, Karnataka, India
  2. Department of Pharmacy Practice, Basaveshwara Medical College and Hospital, Chitradurga, Karnataka, India
  3. Department of Biochemistry, Basaveshwara Medical College and Hospital, Chitradurga, Karnataka, India.
Corresponding Author: Mohamed Murtuza Kauser, Department of Medicine, Basaveshwara Medical College and Hospital, Chitradurga, Karnataka, India. Received: 22 August 2014 Accepted: 26 September 2014

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Research & Reviews: Journal of Medical and Health Sciences

Abstract

India is undergoing rapid epidemiological transition as a consequence of economic and social change. The pattern of mortality is a key indicator of the consequent health effects but up-to-date, precise, and reliable statistics are few, particularly in rural areas. The pattern of diseases in developing countries is very different than those in developed ones. In a typical developing country, most deaths result from infectious and parasitic diseases, abetted by malnutrition. In India, about 40% of deaths are from infectious, parasitic and respiratory diseases as compared with 8% in developed countries. The Main aim of present study is to study the mortality pattern with sociodemographic characteristics of non medico legal deaths which occurred in Basaveshwara medical college & Hospital, Chitradurga. A retrospective study was done with Death records from medical record section of patients in Basaveshwara medical college and Hospital, A tertiary care hospital Chitradurga. All case records of indoor patients after discharge or death, except deaths of medico legal cases, are submitted in the Medical Record Section that works under Community Medicine Department, BMCH, Chitradurga. All deaths that occurred during the 5-year period, i.e., 2009-20013, except medico legal, Pediatric and OBG deaths were considered for Study. The mortality rate of 17.21, 18.79, 17.66, 19.18, and 15.50 per 1000 admissions from 2009 to 2013 respectively. Most deaths are seen in males than females. Mortality from people of rural is higher than urban. Major proportion of deaths were in >60years. Knowledge of mortality pattern which may vary from region to region is crucial in formulating health care programs and policies.

Keywords
Mortality, Sociodemographic, Epidemiology.

Introduction
Patterns of mortality decline that occur with the demographic transition is a change in the distribution of deaths by cause away from a pattern dominated by communicable diseases toward one in which non-communicable diseases account for the overwhelming majority of deaths. This process, known as the epidemiologic transition.[1] Life expectancy in India shows a continuous increasing trend from 23.63 years for male and 23.96 years for females in 1901 it has gone up to 63.9 years for males and 66.9 years for females in 2001.[2]
India is undergoing rapid epidemiological transition as a consequence of economic and social change. The pattern of mortality is a key indicator of the consequent health effects but up-to-date, precise, and reliable statistics are few, particularly in rural areas.[3]
Mortality statistics reveal much about the health of the population: Once derived statistics and life expectation at birth and at various subsequent ages is often cited as an indicator of population health when comparisons are made over time and between nations for designing intervention programs, allocation of resources and indicating priorities. It is essential to know the frequency of disease or death, but this is not static, and keeps changing. It is also important to decide whether the observed change reflects change in incidence, in case fatality or both. It is equally important to determine whether the observed trend in mortality is genuine or is it due to change in nomenclature or classification of disease, changes in accuracy of diagnosis or changes in the statistical classification or allocation of priorities. [4]
The pattern of diseases in developing countries is very different than those in developed ones. In a typical developing country, most deaths result from infectious and parasitic diseases, abetted by malnutrition. In India, about 40% of deaths are from infectious, parasitic and respiratory diseases as compared with 8% in developed countries. [5]
The age, gender and cause-specific mortality rates by residence are essential indicators which help in monitoring health trends in the population. [6]
Mortality data from hospitalized patients gives the causes of major illnesses and care-seeking behavior of the community as well as the standard of care being provided. Records of vital events like death, provide an important component of the Health Information System. Hospital-based death records provide information regarding the causes of deaths, case fatality rates and age and sex distribution, which are of great importance in planning health care services. [4]
The Main aim of present study is to study the mortality pattern with sociodemographic characteristics of non medico legal deaths which occurred in Basweshwara medical college & Hospital, Chitradurga.

METHODOLOGY
A retrospective study was done with Death records from medical record section of patients in Basveshwara medical college & Hospital, A tertiary care hospital Chitradurga.
All case records of indoor patients after discharge or death, except deaths of medico legal cases, are submitted in the Medical Record Section that works under Community Medicine Department, BMCH, Chitradurga. All deaths that occurred during the 5-year period, i.e., 2009-20013, except medico legal, Paediatric and OBG deaths were considered for Study. The underlying cause of death was classified according to I.C.D. 10th revision. Name, age, gender, date of admission, place of residence, date of death and underlying cause of death were used for study. Data was summarized by using SPSS 19th version. Approval of institutional ethical committee was obtained prior to the study.

Results
A total of 833 deaths were registered in 5years from 2009-2013 in Medical Records Sections of Basaveshwara Medical College and hospital, Chitradurga. The Study includes 493 out of 833 deaths which excludes medico legal deaths, OBG and Paediatric. Mortality rate was calculated per 1000 inpatient admissions. The mortality rate of 17.21, 18.79, 17.66, 19.18, and 15.50 per 1000 admissions from 2009 to 2013 respectively. Most deaths are seen in males than females. Mortality from people of rural is higher than urban. Major proportion of deaths were in >60years (Table 1).
The Cause of Death of Patients was classified according System wise classification shown in Table 3, the major portion of deaths were occurred due Cardio Vascular disorders(IHD, HTN, Heart Failure & Arrhythmias) and next leading cause was Respiratory Diseases than followed by Infectious Diseases (HIV,TB, Dengue, etc.) (Figure 1). The Cause of death is more in Non-Communicable diseases compared to that of Communicable diseases (Table 2).

Discussion
The present study has shown that the significant cause of death involved Cardio Vascular Disease with uneven mortality rate. Holambe V.M et al reported linearity in mortality rate. [7] A similar finding was reported by Joshi et al. [8]
Male deaths were more than female deaths which has been documented in various studies. [7-11] whereas rural deaths were more than urban deaths. This may be due to poverty which is more prevalent in rural areas or patients were referred from Primary Health Centers to the hospital in terminal stage of their illness, whereas the urban population has more access to private hospitals/clinics. The Cause of death is more in Non-Communicable diseases compared to that of Communicable diseases, there is an upward trend of non-communicable diseases as leading cause of death due to many reasons such as change in lifestyle and behaviour. [5] We found CVD deaths to be 27.5%, which was higher percentage than all other diseases, Similar findings were seen in Peres LC et al.[13]
In the present study a major proportion of hospital deaths were in patients >60 years followed by 46-60 years and 16-45 years. Holambe V.M et al also reported the same. [7]

Conclusion
Knowledge of mortality pattern which may vary from region to region is crucial in formulating health care programs and policies.

Tables at a glance
Table icon  Table icon  Table icon  Table icon
Table 1  Table 2  Table 3  Table 4



Figures at a glance
Figure 1  Figure 2
Figure 1  Figure 2

References