In-hospital deaths attributable to healthcare-associated infections

It is estimated that approximately one-third of in-hospital deaths in Norway are attributable to adverse events, while the proportion caused by infection is unknown. Oslo University Hospital provides a full range of medical specialties on a national and regional level while serving as a local hospital for a population of approximately 300 000. We wished to investigate in-hospital deaths associated with fatal adverse events, and healthcare-associated infections in particular.

The study is based on a review of the medical records for all patients who died in Oslo University Hospital's somatic units in 2011. Infections were classified according to the criteria of the Centers for Disease Control and Prevention, USA.

Out of a total of 82 341 admitted patients, 1 126 died while in hospital. We identified life-shortening adverse events in 128 (11.4 %) of these. The 87 patients at Ullevål hospital had a mean age of 73 years, while the 41 patients at Rikshospitalet/the Norwegian Radium Hospital had a mean age of 62 years. A total of 108 patients (9.6 %) died from a healthcare-associated infection, 49 of whom had a predicted survival of more than four weeks (4.4 % of the fatalities). Fifty-eight patients had pneumonia.

The proportion of deaths that were attributable to adverse events was lower than previously estimated in Norway. Oslo University Hospital, with its combined functions and broad patient base, can provide representative figures for healthcare-associated infections with fatal outcome in Norwegian hospitals.