ANALYSIS OF ORGANIZATIONAL AND CLINICAL ASPECTS OF SUDDEN DEATH IN A MULTIDISCIPLINARY HOSPITAL
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Abstract
Purpose of the study – to identify the key organizational and clinical causes of sudden death in a multidisciplinary hospital in order to develop practical recommendations aimed at reducing preventable losses.
Materials and methods. A retrospective analysis was conducted of 226 medical records of patients who died from sudden death at the KGBUZ «Regional Clinical Hospital» between 2018 and 2023. Data extraction methods, structural analysis (calculation of extensive indicators), and logical analysis were used.
Results. It was found that among the examined patients, women accounted for 51.8% and men for 48.2%. The main risk group consisted of elderly and senile patients with a high burden of comorbidity and predominantly emergency admission. Analysis of patient flow showed that most patients were admitted emergently (92.5%). The key organizational risk factor was a short hospital stay before death, indicating decompensation at the time of admission: more than half of the patients died within the first week of hospitalization. Assessment of the severity of condition at admission showed that more than half were in severe or extremely severe condition. Clinical characteristics revealed a high level of comorbidity in 96% of patients and severe multimorbidity in 71%, with a significant contribution of coronary artery disease. About half of the patients had a markedly limited functional status.
Conclusion. Based on the obtained data, practical recommendations for risk stratification were developed to enable timely intervention and reduce preventable losses.
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1. Boytsov SA, Nikulina NN, Yakushin SS, Akinina SA, Furmenko GI. Sudden cardiac death in patients with coronary heart disease according to the results of the Russian multicenter epidemiological study of morbidity, mortality, quality of diagnosis and treatment of acute forms of CHD (RESONANCE). Russian Journal of Cardiology. 2011; 2: 59-64. Russian (Бойцов С.А., Никулина Н.Н., Якушин С.С., Акинина С.А., Фурменко Г.И. Внезапная сердечная смерть у больных ишемической болезнью сердца по результатам Российского многоцентрового эпидемиологического исследования заболеваемости, смертности, качества диагностики и лечения острых форм ИБС (РЕЗОНАНС) //Российский кардиологический журнал. 2011. № 2. С. 59-64)
2. Boytsov SA, Ipatov PV, Krotov AV. Pre-hospital management role in cardiovascular mortality and lethality reduction. Cardiovascular Therapy and Prevention. 2007; 6(4): 86-95. Russian (Бойцов С.А., Ипатов П.В., Кротов А.В. Смертность и летальность от болезней системы кровообращения, актуальность развития первой помощи для их снижения //Кардиоваскулярная терапия и профилактика. 2007. Т. 6, № 4. С. 86-95)
3. Mamedov MN. Global dynamics of mortality from cardiovascular diseases in different regions of the world. International Journal of Heart and Vascular Diseases. 2025; 13(46): 5-11. Russian (Мамедов М.Н. Глобальная динамика смертности от сердечно-сосудистых заболеваний в различных регионах мира //Международный журнал сердца и сосудистых заболеваний. 2025. Т. 13, № 46. С. 5-11.) doi: 10.24412/2311-1623-2025-46-5-1
4. Nikolaev YuA, Mitrofanov IM, Pospelova TI, Dolgova NA, Polyakov VYa. Features of modern polymorbidity internal medicine. Byulleten' Sibirskogo otdeleniya Rossiyskoy akademii meditsinskikh nauk. 2014; 34(2): 44-49. Russian (Николаев Ю.А., Митрофанов И.М., Поспелова Т.И., Долгова Н.А., Поляков В.Я. Особенности полиморбидности в современной клинике внутренних болезней //Бюллетень Сибирского отделения Российской академии медицинских наук. 2014. Т. 34, № 2. С. 44-49)
5. Sevostyanova EV, Nikolaev YuA, Polyakov VYa. The problem of polymorbidity in a modern therapeutic clinic. Bulletin of Siberian Medicine. 2022; 21(1): 162-170. Russian (Севостьянова Е.В., Николаев Ю.А., Поляков В.Я. Проблема полиморбидности в современной терапевтической клинике //Бюллетень сибирской медицины. 2022. Т. 21, № 1. С. 162-170.) doi: 10.20538/1682-0363-2022-1-162-170
6. Fortin M, Bravo G, Hudon C, Vanasse A, Lapointe L. Prevalence of multimorbidity among adults seen in family practice. Ann Fam Med. 2005; 3(3): 223-228. doi: 10.1370/afm.272
7. Mikheeva OM, Komissarenko IA. Metabolic syndrome as part of polymorbidity problem. Effective Pharmacotherapy. Cardiology and angiology. 2013; 3(43): 10-18. Russian (Михеева О.М., Комиссаренко И.А. Метаболический синдром как проблема полиморбидности //Эффективная фармакотерапия. Кардиология и ангиология. 2013. № 3(43). С. 10-18)
8. Violan C, Foguet-Boreu Q, Flores-Mateo G, Salisbury C, Blom J, Freitag M, et al. Prevalence, determinants and patterns of multimorbidity in primary care: a systematic review of observational studies. PLoS One. 2014; 9(7): 102149. doi: 10.1371/journal.pone.0102149
9. Niv Y, Tal Y. Risk Management and Patient Safety Processes in a Healthcare Organization. In book: Patient Safety and Risk Management in Medicine (pp.129-174). Cham: Springer; 2023. doi: 10.1007/978-3-031-49865-7_11
10. Borovkova NYu, Eliseeva LYu, Tokareva AS, Zubeev PS, Zubeeva GN. Prediction of fatal outcome in hospital patients with COVID-19 and comorbid pathology. Therapist's Bulletin. 2024; 3(64): 11-19. Russian (Боровкова Н.Ю., Елисеева Л.Ю., Токарева А.С., Зубеев П.С., Зубеева Г.Н. Прогнозирование летального исхода у госпитальных пациентов с COVID-19 и коморбидной патологией //Вестник терапевта. 2024. № 3(64). С. 11-19.) doi: 10.31550/2712-8601-VT-2024-3-2
11. Barnett K, Mercer SW, Norbury M, Watt G, Wyke S, Guthrie B. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet. 2012; 380(9836): 37-43. doi: 10.1016/S0140-6736(12)60240-2