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Open AccessArticle

Factors Associated with In-Hospital Mortality in Acute Care Hospital Settings: A Prospective Observational Study

1
Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, 41009 Seville, Spain
2
Research Group under the Andalusian Research, Development and Innovation Scheme CTS-1019 Complex Care, Chronic and Health Outcomes, Universidad de Sevilla, 41009 Seville, Spain
3
Hospital San Agustín de Linares, Servicio Andaluz de Salud, 23700 Linares (Jaen), Spain
4
Hospital Santa Ana de Motril Hospital, Servicio Andaluz de Salud, 18600 Motril (Granada), Spain
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(21), 7951; https://doi.org/10.3390/ijerph17217951
Received: 6 October 2020 / Revised: 22 October 2020 / Accepted: 26 October 2020 / Published: 29 October 2020
(This article belongs to the Special Issue Nursing Research)
Background: In-hospital mortality is a key indicator of the quality of care. Studies so far have demonstrated the influence of patient and hospital-related factors on in-hospital mortality. Currently, new variables, such as nursing workload or the level of dependency, are being incorporated. We aimed to identify which individual, clinical and hospital characteristics are related to hospital mortality. Methods: A multicentre prospective observational study design was used. Sampling was conducted between February 2015 and October 2017. Patients over 16 years, admitted to medical or surgical units at 11 public hospitals in Andalusia (Spain), with a foreseeable stay of at least 48 h were included. Multivariate regression analyses were performed to analyse the data. Results: The sample consisted of 3821 assessments conducted in 1004 patients. The mean profile was that of a male (52%), mean age of 64.5 years old, admitted to a medical unit (56.5%), with an informal caregiver (60%). In-hospital mortality was 4%. The INICIARE (Inventario del Nivel de Cuidados Mediante Indicadores de Clasificación de Resultados de Enfermería) scale yielded an adjusted odds ratio [AOR] of 0.987 (95% confidence interval [CI]: 0.97–0.99) and the nurse staffing level (NSL) yielded an AOR of 1.197 (95% CI: 1.02–1.4). Conclusion: Nursing care dependency measured by INICIARE and nurse staffing level was associated with in-hospital mortality. View Full-Text
Keywords: hospital mortality; nursing care dependency; nursing staffing level; observational study; multivariate analysis hospital mortality; nursing care dependency; nursing staffing level; observational study; multivariate analysis
MDPI and ACS Style

Porcel-Gálvez, A.M.; Barrientos-Trigo, S.; Gil-García, E.; Aguilera-Castillo, O.; Pérez-Fernández, A.J.; Fernández-García, E. Factors Associated with In-Hospital Mortality in Acute Care Hospital Settings: A Prospective Observational Study. Int. J. Environ. Res. Public Health 2020, 17, 7951.

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