gms | German Medical Science

Background: In national epidemiological studies sepsis was shown to be the most common cause of death in surgical patients, but there are poor data about mortality and its association to infections for hospitals or departments. However, department specific data are mandatory for improving results. The aim of our study was to evaluate the impact of infections on mortality in unselected, routinely admitted patients of a single surgical department.

Materials and methods: We retrospectively reviewed 3020 patients who were admitted to our department between March and December 2014. Deaths were assigned to one of five categories (preexisting infection at admission, postoperative infection, cardiopulmonary death, bleeding, terminal stage of disease) by chart review.

Results: There were 33 (1.1%) deaths of 3020 patients admitted during the study period. Mean age was 74 +/- 14 years (range 39 – 98), 20 patients were female (61%). 25 (76%) of deceased patients were admitted as an emergency.

Death was associated with infection in 20 (61%) patients, in the majority the origin of infection was the abdomen (13/20 patients). 16 (80%) of them were admitted with infections and 4 died from postoperative infection. Cardiopulmonary failure (5 of 33, 15.2%), bleeding (one of 33, 3%) and terminal stage of disease (7 of 33, 21.2%) were categories of death not associated with infection.

Median time period between initial surgery and death was 11.5 days (median, range 0 – 156 days).

Conclusion: Infection was the most common cause of death in a department specific analysis. Remarkably, the majority of finally lethal infections were preexisting and the basic cause for hospitalisation. The results are specific for our department and need meticulous work up with respect to patients’ risk factors, and the timeline and choice of diagnostic and therapeutic procedures undertaken. These data should be included in the departments’ morbidity and mortality conference to optimise clinical outcome.