Cuidados paliativos y medicina

Abstracto

Mortality at a Portuguese Internal Medicine Service: Is Patient Allocation a Determinant Factor?

Luciana Sousa, Ana Rita Marques, Inês Burmester, Isabel Apolinário and Ilídio Brandão

Objectives: To verify if patient’s allocation by different wards is a determinant factor of mortality risk.

Design: Retrospective longitudinal study, using individual patient data from Internal Medicine Service in Hospital de Braga, Portugal.

Setting: From 1st to 31th January 2015.

Participants were eligible to our study all patients admitted do Internal Medical care, who hadn’t been transferred from different specialty’s wards during hospitalization or remained at Intermediate Care Unit in Emergency Room more than 24 hours.

Main outcome measures: Patients admitted to Internal Medicine’s wards and those admitted on other specialty’s wards, were compared for all-cause mortality, 2nd day mortality means and time to death. Analyses using t-student test and χ2 test (SPSS Statistics 22.0).

Results: A total of 319 patients were included in our study, 49.5% (158) were admitted to our medical wards and 50.5% (161) were admitted to a different specialty ward. There were respectively 16.5% (26) and 18.6% (30) total deaths and 3.8% (1) and 23.3% (7) 2nd day mortality. We also find that Internal Medicine ward time to death was 12.0 days and other inpatient ward time to death was 6.13 days. There was no statistically significant difference between groups for all-cause mortality (t(317)=-0.510; p=0.611; d=0.07), but for 2nd day mortality and time to death we found a statistic significant difference (t(44)=2.11; p=0.04; d=-0.56) and (t(37.2)=3.32; p-value=0.002; d=0.92) respectively.

Conclusions: The present study highlight “patient allocation” as a determinant factor for early mortality risk. Further research is needed to understand which morbidity and mortality factors are associated with these findings.