[Early hospital mortality due to XXXX ].

@entity1 @entity295 @entity55 @entity281 @entity1729 @entity204 @entity166
BACKGROUND: @entity166 are an important health problem. Early hospital mortality (EHM) (first 48 hours after hospital admission) give us information about the etiology and the focus of @entity281 . This study was designed because no articles have been found about this subject. MATERIAL AND METHODS: We reviewed the medical records coded by the ICD-9-CM of all @entity1 that suffered from EHM due to @entity166 during the period 1992 to 1999. RESULTS: Of all the @entity1 analyzed, 0.7% died of EHM, and of theses, 6.9% were due to an @entity166 . Median age was 73.2 years; 56.1% were @entity1 . Index of comorbidity was higher than 1 in 59,9%, and 70,7% never has been admitted to the hospital before. At admission, fever was present in 43.9%. The illness severity was 60.9% @entity295 , 24.4% severe @entity295 , 13.4% septic shock and 1.2% multiorgan failure. Causes of @entity204 were respiratory (76.8%; @entity55 58.5%). @entity55 was more frequent among aged 65 years and older (p = 0.03). In 69.5% no microbiological techniques were performed with independence of the clinical severity or the presence or absence of fever. In 85.4% the casual agent was unidentified, but in the case of isolation, gram positive was the most frequent microorganism. CONCLUSIONS: Infections are an important cause of EHM, and community-acquired @entity1729 (mainly @entity55 ) the most frequent cause of EHM. @entity1 were admitted to the hospital with @entity295 in 60.9%, perhaps due to a diagnostic or therapeutic delay. Among aged 65 years and older, microbiological diagnostic procedures were rarely employed.
