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Cardiovascular causes of death at Tshepong Hospital in 1 year, 1989-1990. A necropsy study
J H Steenekamp1, I W Simson, W Theron
1Department of Internal Medicine, Klerksdorp Hospital Complex.
Insights
Cardiovascular disease is a leading cause of death, particularly in adults over 35. This study highlights the importance of necropsies for accurate mortality statistics and understanding co-existing conditions in cardiovascular deaths.
Area of Science:
- Cardiology
- Pathology
- Public Health
Background:
- Cardiovascular disease (CVD) is a significant cause of mortality in Tshepong Hospital, western Transvaal.
- It is the most common cause of death for patients over 35 years old.
Purpose of the Study:
- To establish a reliable mortality pattern for cardiovascular deaths.
- To investigate co-existing conditions associated with cardiovascular disease.
- To compare clinical diagnoses with necropsy findings.
Main Methods:
- Prospective study over one year.
- Inclusion of limited necropsies in 90 out of 167 cardiovascular disease deaths.
- Evaluation of co-existing conditions including hypertension, nephrosclerosis, atherosclerosis, obesity, and tuberculosis.
Main Results:
- Cerebrovascular conditions were present in 32% of cardiovascular deaths (intracerebral haemorrhage in 50%, cerebral infarction in 29%).
- Cardiac conditions accounted for 57% of deaths, with pulmonary hypertension (31%) being most common.
- Hypertension (49%), benign nephrosclerosis (40%), and tuberculosis (13%) were prevalent; severe atherosclerosis was rare (3%).
- Clinical diagnosis matched necropsy diagnosis in only 38% of cases.
Conclusions:
- Necropsies are crucial for obtaining accurate cardiovascular disease mortality statistics.
- Understanding co-existing conditions is vital for comprehensive patient care and public health strategies.
- Discrepancies between clinical and necropsy diagnoses underscore the need for improved diagnostic accuracy.
Abstract:
Cardiovascular disease is the third most common cause of death in Tshepong Hospital in the western Transvaal, and the most common cause of death in patients older than 35 years. A prospective study was undertaken which included limited necropsies in 90 of the 167 cardiovascular disease deaths over 1 year. A reliable mortality pattern for cardiovascular deaths is described. Additionally, attention is paid to co-existing conditions. Conditions relating to cardiovascular disease, such as hypertension, benign hypertensive nephrosclerosis, atherosclerosis and obesity, were also evaluated. Cerebrovascular conditions were found in 32% of cardiovascular deaths. Intracerebral haemorrhage was found in 50% and cerebral infarction in 29% of cases. Fifty-seven per cent of cardiovascular deaths were due to cardiac conditions, the most common being pulmonary hypertension (31%), dilated cardiomyopathy and chronic rheumatic valvular disease (17% each) and hypertensive heart disease (14%). Forty-nine per cent of subjects were hypertensive, while 40% exhibited benign nephrosclerosis and only 3% of the examined vessels had signs of severe atherosclerosis. Tuberculosis was present in 13% of cases. The clinical diagnosis was the same as the final necropsy diagnosis in 38% of cases. These results emphasise the importance of performing necropsies to obtain reliable mortality statistics.
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