Antecedents to hospital deaths

Intern Med J. 2001 Aug;31(6):343-8. doi: 10.1046/j.1445-5994.2001.00077.x.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Female
  • Heart Arrest / mortality
  • Heart Arrest / prevention & control*
  • Heart Rate
  • Hospital Mortality*
  • Humans
  • Hypotension / complications
  • Hypotension / diagnosis
  • Intensive Care Units
  • Length of Stay
  • Male
  • Middle Aged
  • Respiration
  • Respiratory Insufficiency / complications
  • Respiratory Insufficiency / diagnosis
  • Resuscitation Orders
  • Risk Factors
  • Time Factors