• Paul G Firth, Rhina Mushagara, Nicholas Musinguzi, Charles Liu, Adeline A Boatin, Walter Mugabi, Dorothy Kayaga, Phionah Naturinda, Deus Twesigye, Frank Sanyu, Godfrey Mugyenyi, Joseph Ngonzi, Stephen S Ttendo, and Mbarara SQUAD Consortium.
• From the Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts.
• Anesth. Analg. 2021 Dec 1; 133 (6): 160816161608-1616.

BackgroundThe health care systems of low-income countries have severely limited capacity to treat surgical diseases and conditions. There is limited information about which hospital mortality outcomes are suitable metrics in these settings.MethodsWe did a 1-year observational cohort study of patient admissions to the Surgery and the Obstetrics and Gynecology departments and of newborns delivered at a Ugandan secondary referral hospital. We examined the proportion of deaths captured by standardized metrics of mortality.ResultsThere were 17,015 admissions and 9612 deliveries. A total of 847 deaths were documented: 385 (45.5%) admission deaths and 462 (54.5%) perinatal deaths. Less than one-third of admission deaths occurred during or after an operation (n = 126/385, 32.7%). Trauma and maternal mortality combined with perioperative mortality produced 79.2% (n = 305/385) of admission deaths. Of 462 perinatal deaths, 412 (90.1%) were stillborn, and 50 (10.9%) were early neonatal deaths. The combined metrics of the trauma mortality rate, maternal mortality ratio, thirty-day perioperative mortality rate, and perinatal mortality rate captured 89.8% (n = 761/847) of all deaths documented at the hospital.ConclusionsThe combination of perinatal, maternal, trauma, and perioperative mortality metrics captured most deaths documented at a Ugandan referral hospital.Copyright © 2021 International Anesthesia Research Society.

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