REVIEW OF ONE YEAR MORTALITY PATTERNS AT THE ACCIDENT AND EMERGENCY OF A TEACHING HOSPITAL IN NORTHERN GHANA

Abstract

Background: The burden of disease in every geographical area is reflected by the diseases patients present to hospital with and die from. Many deaths in hospitals occur in the emergency department. We sought to describe the mortality rate, patterns, and causes of death in the Accident and Emergency (A&E) Department of Tamale Teaching Hospital. Methods: This was a retrospective review of deaths that occurred in the Accident and Emergency Department from January to December 2016. Information was gathered from death registers, folders, nurses’ notes, and admission and discharge books. Results: In 2016, 7,369 patients visited the A&E and 215 died, with a mortality rate of 2.9%. The age range of patients who died was 3-93 years. Most deaths (121, 50.2%) occurred in patients aged 50 years and above. Over 60% of the deaths occurred in the first 24 hours. Most (69%) deaths were due to a medical cause. The leading individual causes were: sepsis (17%), trauma (16%), cerebrovascular accident (12%), and pneumonia (9%). The peak age group of medical deaths was 70-79 (eighth decade) years and peak age of surgical deaths was 30-39 years. Most patients (77%) died in the absence of an emergency physician. Conclusion: The mortality of 2.9% can be reduced. The first 24 hours in the emergency is crucial since most of our patients died in this period and in the absence of an emergency physician on duty. In addition to increasing the equipment and supplies in the emergency department, increasing the number and availability of emergency physicians and improvement in records keeping will have an important role.