Four-year overall surgical mortality rate at Princess Marina Hospital, a tertiary hospital in Botswana

HTML: 9
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Background. Improving surgical mortality rates is a global priority as they measure the success of surgical care systems. There is no data on Botswana’s overall surgical mortality rate. Therefore, this study set out to evaluate the overall mortality rate in a surgical department at Princess Marina Hospital, a tertiary hospital in Botswana.
Method. This study is a single-center quantitative and retrospective study conducted in the surgical department at Princess Marina Hospital from August 2016 to December 2019. The Department of Surgery at Princess Marina Hospital keeps a prospectively updated database for quality assurance, which started in August 2016. The study received ethical approval. We included all patients older than 12 years admitted to the surgical department. Our adults surgical wards admit patients who are older than 12 years. This study collected all mortality data and determined the overall mortality rate as a percentage of surgical admissions.
Results. We retrieved 4660 admissions. The mean age was 56 (standard deviation=20.1). 66% (3083/4660) were operated. Out of the 4660 admissions, 267 deaths were registered, giving an overall mortality rate of 6%. The overall postoperative mortality rate was 3.63% (112/3083), and the non-operatively managed patient mortality rate 9.83% (155/1577). Overall, malignancies were the leading cause of death, at 49.1%(131/267), followed by trauma at 22.1% (59/267).
Conclusions. The 4-year overall surgical mortality rate at Princess Marina Hospital was 6%. The mortality rate of the non-operatively managed patients was more than twice as high as the postoperative mortality rate. Overall, malignancies were the leading cause of death, followed by trauma.
Heeney A, Hand F, Bates J, et al. Surgical mortality - an analysis of all deaths within a general surgical department. Surgeon 2014;12:121-8. DOI: https://doi.org/10.1016/j.surge.2013.07.005
Nepogodiev D, Martin J, Biccard B, et al. Global burden of postoperative death. Lancet 2019;393:401. DOI: https://doi.org/10.1016/S0140-6736(18)33139-8
Bergström S, McPake B, Pereira C, et al. Workforce innovations to expand the capacity for surgical services. Disease control priorities 2015;1:307-16. DOI: https://doi.org/10.1596/978-1-4648-0346-8_ch17
Bruns SD, Davis BR, Demirjian AN, et al. The subspecialization of surgery: a paradigm shift. J Gastrointest Surg 2014;18:1523-31. DOI: https://doi.org/10.1007/s11605-014-2514-4
Biluts H, Bekele A, Kottiso B, et al. In-patient surgical mortality in Tikur Anbessa Hospital: a five-year review. Ethiop Med J 2009;47:135-42.
World Health Organization. Guidelines for trauma quality improvement programmes. 2009.
Rights
Open AccessCopyright (c) 2023 the Authors

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.