[Mortality in an internal medicine department within a third-level hospital; twenty years experience]

To know and to analyze the main causes of death in an Internal Medicine Department (IM) and the mortality rate in such a Department.

From 1977 to 1996, a total of 77,310 patients were attended in the service under analysis. There were a total of 4,720 deaths. Clinical and epidemiological variables were analyzed so do management parameters related to inpatient deaths.

Global mortality rate was 6.1%; the number of admissions increased along the study, whereas mortality rate tended to decrease. Median age was 72.8 years in death patients, and this age tended to increase during the period of study. Women's age was greater than men's one. The causes of the demise were cardiovascular (stroke and cardiopathy), neoplasm and respiratory disease, in that order. Neoplastic diseases were the leading death cause in men as they were in patients younger than 65 years-old, and AIDS was the main reason of death in patients younger than 35 years. Finally, 28.7% who died had been inpatients for no more than 48 hours.

We can conclude that deaths in our IM department affect, as a rule, elderly patients with cardiovascular or neoplastic disease. Moreover, AIDS has experienced an increasing frequency, so it had became the first cause of death in patients under the age of 35. The old age of patients who die in our service, the great percentage of early deaths and the fact that the motive was, in the majority of the patients, a terminal disease, support the idea that new social customs tend to remove illness and death from family home, approving demise as a hospital event.