Five-year mortality rate in an ophthalmic ward in Zimbabwe

Objective: To determine the mortality rate in the ophthalmic ward at the Sekuru Kaguvi Hospital Eye Unit (SKHEU), Zimbabwe, from January 2009 to December 2013 and to identify the causes of death. Design: A hospital-based clinical audit. Methods: Data from completed hospital death notification forms and medical records of patients who had died in the ward during the review period were collected that included age, gender, diagnoses, date of admission, date of death and cause of death. The data were analysed using Epi Info7 software. Setting: The audit was conducted at SKHEU, the largest tertiary eye unit in Zimbabwe. It comprises an ophthalmic ward with 30 beds and caters for about 900 patients per year. Patients are admitted via the Out-patients Department where about 30 000 patients are seen yearly. SKHEU is part of the Parirenyatwa Group of Hospitals, which is one of the four major referral hospitals in Zimbabwe. Results: Of the 4722 ophthalmic admissions at SKHEU during the 5-year study period, there were 15 (0.3%) deaths, with a male: female ratio of 3: 2 giving a mortality rate of 0.3% and an average of 3 deaths per year. The highest number of deaths was in 2009 when 7 deaths occurred, whilst the lowest number was 1 death in 2010 and 1 in 2013. Of the 15 deaths, 4(26.7%) were children < 12 years old and 11 (73.3%) were adults; of whom 12 (80%) patients had orbital malignancies, 2 (13.3%) had orbital cellulitis and 1 (6.7%) had ocular trauma. The orbital malignancies included ocular surface squamous neoplasia (OSSN), retinoblastoma and non-Hodgkins lymphoma (NHL). The most common probable cause of death was OSSN which accounted for 9 (60%) of the deaths. Conclusion: The mortality rate at SKHEU was 0.3%, with approximately 3 deaths occurring per year. The most common attributable cause of death was OSSN.