Time trends in inhospital mortality. A retrospective study in Romania 2014-2019

C. Vladescu, M. Ciutan, S. Musat

Abstract: The inhospital mortality is on an ascending trend in the last 6 years, both at the national level and also at regional level, for all the eight Romanian regions. From 2014 to 2019 there was reported an increase from 63,117 cases to 83,113 cases of inhospital deaths, representing an increase from 24.7% to 31.4% from the total mortality in Romania. Mortality for emergency cases vs. non-emergency cases was four times higher, both at national and at regional level (3.3% vs. 0.76%). The analysis of time correlation between hospital admission and mortality was done for the first time in Romania, and showed a direct correlation between the time of admission and the risk of dying in the first 24 hours (corr. = 0.81; p-value <0.05); the risk of dying for patients admitted at 8PM was over 10 times higher than for patients admitted at 8 AM. The risk of dying was also explored by the patient hospital admission day; despite the fact that on Saturday and Sunday there are fewer hospital admissions, the risk of death, in the first 24 hours, of these patients (10% on Sunday and over 8% on Saturday) is significantly higher than for those admitted on the rest of the week days (0-4%); these data are in concordance with the so-called weekend effect described in literature, that describe a rise in mortality for weekend admissions.
Keywords: death, hospital, mortality,admission, risk of mortality.