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CIRCULATORY SYSTEM :HOSPITAL STATISTICS (1997)

Atul Shah*, HL Dhar**

*Senior Statistician; **Director, Medical Research Centre, Bombay Hospital Trust.

In 1997, total in-patients admitted were 26367 from which 7733 were admitted under circulatory system. (ICD code I.00 I-99). All these 7733 were sorted according to ten main blocks of ICD code and they were analysed according to age and sex M (72.39%), F (27.61%). Amongst all age groups 50% of total admission were in the age group of 41-60 years.

5512 (71%) of 7733 patients were admitted in cardiothoracic units. Rest were admitted in other units but suffering from cardiac problems as follows : General Medicine (708), General Surgery (328), Neurology (586), Neuro surgery (172), Paediatric (70); Obst. and Gynaecology (30), Orthopaedic (62), Urology (211), Ophthalmology (9), Cancer (38) and ENT (7).

Maximum stay in the hospital was upto first week (51.66%) and minimum upto one month (4.7%). Out of total of 705 patients who died in the hospital during the year, 358 (50.78%) were from circulatory system.

INTRODUCTION

Earlier we have reported mortality rate in Bombay Hospital in-patients 1993.[1] Recently 6 years study on mortality in Bombay Hospital is in press.[2]

Present study deals with hospital statistics (1997) on circulatory system.

PATIENTS AND METHODS

Indoor case papers are labelled under ICD-10 code based on diagnosis. In-patient cardex file contains indoor no., name, sex, age, honoraries under whom patient is admitted, hospital stay and deaths if any. Data on disorders of circulatory system were analysed according to ICD code (I.00 TO I.99)[3] and grouped into ten main blocks as shown in Table 1.

RESULTS

Total indoor admissions in 1997 (Jan-Dec) were 26367. Out of which 5512 (20.90%) were admitted in cardiac units (either for medical or surgical treatment), 2221 (8.42%) were admitted in other units but diagnosed as having some cardiac disorders making a total of 7733 patients (29.32%) under diseases of circulatory system. Age and Sex distribution has been shown in Table 2 indicating males preponderance (72.39%) over female (27.61%). Nearly 50% of patients were in the age group of 41 to 60 years and 32% were elderly above 60 years. Out of 705 deaths in the hospital during the year 1997, 358 (50.78%) deaths were from the patients of circulatory system.

TABLE 1
Main Blocks of Circulatory System
Blocks ICD Code No.
I. Acute Rheumatic Fever (I-00 to I-02)
II. Ch. Rheumatic heart diseases (I-05 to I-09)
III. Hypertensive Diseases (I-10 to I-15)
IV. Ischaemic Heart Diseases (I-20 to I-25)
V. Pulmonary Heart Diseases and Diseases of Pulmonary Circulation (I-26 to I-28)
VI. Other forms of Heart Diseases (I-30 to I-52)
VII. Cerebrovascular Diseases (I-60 to I-69)
VIII. Diseases of Arteries, Arterioles and capillaries (I-70 to I-79)
IX. Diseases of Veins, Lymphatic- Vessels, Lymphnodes, not elsewhere classified (I-80 to I-89)
X. Other and unspecified disorders of the circulatory system (I-95 to I-99)

 

TABLE 2
Age and sex distribution
Age
Sex Upto 20 21-40 41-60 61 & Above Total
Male 202 771 2909 1716 5598
% (2.61) (9.97) (37.62) (22.19) (72.39)
Female 87 375 900 773 2133
% (1.12) (4.85) (11.64) (10.00) (27.61)
Total 289 1146 3809 2489 7733
% (3.73) (14.82) (49.26) (32.19) (100)



TABLE 3
Other forms of heart diseases
Other forms of Heart Diseases Nos.
Cardiac Arrest 681
Heart Failure 244
Paroxysmal Tachycardia and Cardiac Arrhythmias 97
Myocarditis and Cardiomyopathy 95
Complication of Heart diseases and classifiedElsewhere 80
Nonrheumatic Mitral valve disorder 50
Nonrheumatic Aortic valve disorder 27
Other diseases of pericardium 25
Acute and subacute endocarditis 13
Valve disorders 6
Acute Pericarditis 3



TABLE 4
Units of Admission
  Cardiology Thorac Surg. Gen. Med. Gen. Surg. Neuro logy Neuro Surg. Other S
Nos.(7733) 4387 1125 708 328 586 172 427
%(100) 56.73 14.54 9.16 4.24 7.58 2.22 5.53



TABLE 5
Hospital Stay
Days
1 2-7 8-24 15-21 22-30 >30 Total
Nos. 781 3029 1637 1042 538 348 7375
% (10.59) (41.07) (22.20) (14.13) (7.29) (4.72) (100)

45% of the total patients of circulatory system (7733) were suffering from ischaemic heart diseases including angina pectoris, acute and subacute myocardial infarction (MI) acute and chronic ischaemic heart disease. 13.33% were suffering from primary and secondary hypertension, hypertensive heart and renal diseases. 17.082% of the patients were suffering with other forms of heart diseases mainly cardiac arrest, heart failure, cardiac arrhythmias, valvular disorders and cardiomyopathy (Table 3). Admission in other than cardiovascular units has been shown in Table 4.

Table 5 shows that 51.66% of the patients stayed in the hospital till one week, 22.2% between 1 week and 2 weeks and only 4.72% stayed for more than a month.

DISCUSSION

This study shows analysis of data of hospital patients admitted during 1997 under circulatory system. Out of total of 7733 admission during the year suffering from cardiovascular disorders, only 4387 were admitted in cardiology and 1125 in thoracic surgery, rest were admitted under various units but suffering from some cardiac disorders.

Out of total admission, 72.4% were male and 27.7% female. But mortality ratio between male and female were not available, however, our earlier work on 6 year mortality in the hospital showed that in the same year (1997) 67.7% male patients died against 32.31% female.[2] Thus showing mortality rate amongst male and female were according to admission.

Maximum number of patients (51%) stayed in the hospital only for 2-7 days, but there was no information how many died within that period. According to our earlier report[2] nearly 50% of death occurred within first 7 days in the same year. Only 358 patients, out of total 7733 (4.63%) patients suffering from cardiovascular disorders died in the hospital during the year. No comparable data is available from other hospital, however, low mortality could be due to improved management and better patient care in the hospital.


REFERENCES

1.Shah AH, Mehrotra PP, Dhar HL. Mortality rate in Bombay Hospital in-patients 1993. Bom Hosp Jour 1997; 39 (3) : 504-7.

2.Mortality in Bombay Hospital - 6 years study. Bom Hosp Jour 2000 42 (1) : 147-48

3.ICD-10 : International statistical classification of diseases and related health problems. World Health Organization (Geneva) Tenth Revision. 1992; I.



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