Mortality profile, adverse events and impact of admission to the Clinical Hospital mortality adult patients Marilia Medical School

Abstract

Hospital mortality is classically related to several factors such as age, severity of the underlying disease and the number of comorbidities. In addition to these factors, some studies suggest that the prognosis of patients also depends on the time and day of hospital admission and some adverse events occurring during hospitalization, including highlighting the infections related to health care. Data show that there may be variability in assistance provided during the day, particularly when they are measured in terms of outcomes, such as mortality, which was higher on Saturdays and Sundays. Similarly, there are some data suggesting that patients admitted at night may have an increased mortality. Furthermore, during hospitalization patients are subject to several incidents, which could potentially have been avoided, called adverse events by WHO. adverse events are associated with increased length of hospital stay and hospital mortality. It is estimated that the incidence of adverse events is around 10% among hospitalized patients and 4.4% to 20.8% of these events can lead to death .The hospital infections or related to health care is a the main adverse events that are exposed patients during hospitalization and therefore one of the main threats to its security. Objectives: to recognize the hospital mortality profile in adults admitted to the Hospital de Clinicas of Marilia; describe the prevalence of adverse events such as nosocomial infections, pressure ulcers, fall, thromboembolic events among patients who died; compare the occurrence of adverse events among medical and surgical patients; evaluate the influence of the day and the time of admission in early and late hospital mortality among medical and surgical patients. Methodology: There will be a retrospective cohort study including adult patients who evolve to death during hospitalization, the clinical and surgical wards of the Clinical Hospital of FAMEMA during the period of one year. Will be collected through standardized record the following data records: age, gender, origin of the patient (emergency room, outpatient, transfer from another hospital, basic health unit, SAMU), day and time of admission, admission diagnosis and associated diagnoses, surgeries (type, elective or emergency), length of stay in the ward, ICU admission, cause of death, day of week and time of death. Adverse events: diagnosed and topography infections (pneumonia, urinary tract infection, infection of the bloodstream, surgical site infection), pressure ulcers, fall registration, thromboembolism. It is expected that this study recognize the profile of mortality in ward inpatients, the frequency of adverse events that are modifiable so that they can plan improvement strategies according to the local reality.