Research Article Open Access Journal of Molecular Biomarkers & Diagnosis J o u r n a l o f M o l e c u l a r B i o m a r k e r s & D i a g n o s i s ISSN: 2155-9929 Pathak et al., J Mol Biomark Diagn 2017, 8:6 DOI: 10.4172/2155-9929.1000362 Volume 8 • Issue 6 • 1000362 J Mol Biomark Diagn, an open access journal ISSN:2155-9929 *Corresponding author: Sujit K. Bhattacharya, Glocal Hospital, Krishnanagore, Nadia, West Bengal, India, Tel: 8697462003; E-mail- sujitkbhattacharya@yahoo.com Received August 21, 2017; Accepted August 26, 2017; Published August 28, 2017 Citation: Pathak S, Bhattacharya D, Banerjee A, Azim S, Bhattacharya SK (2017) Restricted Analysis of Mortality in an Acute Care Facility of a Rural Hospital in Bengal, India. J Mol Biomark Diagn 8: 362. doi: 10.4172/2155-9929.1000362 Copyright: © 2017 Pathak S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Restricted Analysis of Mortality in an Acute Care Facility of a Rural Hospital in Bengal, India Pathak S, Bhattacharya D, Banerjee A, Azim S and Bhattacharya SK* Glocal Hospital, Krishnanagore, Nadia, West Bengal, India Abstract Advances in acute care medicine have increased the chances of survival for patients with severe illness or trauma. The major causes of modifable and non-modifable mortality among patients treated in medical or surgical intensive care units (ICUs) are trauma, sepsis, complications of diabetes mellitus type 2 and hypertension, respiratory support, CVA, electrolyte imbalance, poisoning and snake bite. Such analysis will give an insight into the various factors which led to death. The pre-hospital co-morbidities will reinforce the internist to anticipate and take appropriate measures to mitigate their onslaught. In this way, the mortality in the ICU may be curtailed. Keywords: Acute care; Ventilation; Mortality; Sepsis; Diabetes; Hypertension; COPD; Trauma Introduction Advances in critical care medicine have increased the chances of survival for patients with severe illness or trauma [1]. However, such patients consume a large proportion of medical resources [2-5]. Te factors for mortality that have potential to be modifed among patients treated in medical or surgical critical care medicine (ICUs) (Figure 1) are sepsis, diabetes mellitus type 2, hypertension, poisoning and snake bite. Understanding the risk factors and their contribution to mortality would support the view that monitoring of patients with above factors is expected to prevent many deaths. Subjects and Methods Study population Patients of both sexes and all ages admitted to the Critical Care Medicine Unit of Glocal Hospital, Krishnanagore were included in this study. Also included were patients transferred from the General Ward to ICU. Post-surgical cases requiring intensive care were also admitted to the ICU. Tere were no exclusion criteria. All patients admitted to acute critical care were interviewed. When required the patient party or accompanying personnel were interviewed. A thorough physical examination followed by relevant investigations was performed. CT scan, MRI, USG were performed in cases, particularly trauma cases and abdominal pain and other cases as required. Informed consent Informed written consent was obtained from all patients or close relatives. In case of children, informed consent was taken from parents. Study period January 1 st , 2016 to 31 st December 2016. Sample size All patients admitted to ICU during one calendar year. Statutory clearances Te Institutional Scientifc Advisory Committee (SAC) and Ethics Committee (EC) cleared the project proposal. Results and Discussion Table 1 shows the distribution of admitted cases Vis-à-vis deaths, age groups, gender and month-wise admissions in the acute care unit of Glocal Hospital (ICU), Krishnanagore, India. A total number of 1130 cases of diverse diseases (males 432 and females 532) and 113 patients died. Tere were more females than males. A case fatality rate of 10% was recorded. Month-wise distribution of admissions showed that more than 100 cases were admitted in January, February, March and October, 2016, Highest number of cases died in the older age group (>60 years). Tere were no obvious admission and mortality trend month-wise. On admission, the case acuity was high with majority of cases presenting to the Emergency (ER) with signs of hemodynamic impairment and sepsis (40%). While neurology deaths cases including CVA cases constituted about one-third of all ER admissions who needed airway protection on admission. Neurology deaths (20%) accounted for large numbers of Cardio Vascular Accidents (CVA) which were hemorrhagic in nature. Many of the neurology cases needed neurosurgical intervention (30%). Higher mortality was observed in cases those who presented with long delay to the ER, long time to Figure 1: Patients treated in medical or surgical intensive care units (ICUs) for trauma, sepsis.