Deaths within hours of hospital admission down

Deaths within hours of hospital admission down

Ram.Sundaram@timesgroup.com  23.06.2020

The number of Covid-19 deaths is steadily increasing in the state, but the percentage of people dying in the first 48 hours after admission to hospital has come down from 54% in May to 35% in June.

Of the 563 deaths in June (till Sunday), 199 were reported within two days of hospitalisation, while in May more than half (90) the 167 deaths occurred within the same time span. “This means more people are being diagnosed early and brought to hospital for treatment,” said former city health officer P Kuganandam.

Data analysed by TOI also showed that the percentage of people who spent more days at the hospital ICUs before they died has gone up. For instance, nearly 41% of the patients spent three days to a week in June, compared to 34% in May. Similarly, the number of patients spending between 8 and 14 days went up from 9% to 19% during the same time period. “It is a good sign as it shows doctors are making adequate efforts to give them high flow oxygen and ventilation,” said public health expert T Sunderraman. “Nevertheless, we experts must do periodic audits to ensure timely intervention,” he said.

Since April, the state and its expert panel added new drugs and debated over protocols almost every day. For instance, in early April, doctors decided oxygen saturation levels were better if they used high-flow oxygen rather than ventilation. Soon, when international studies showed remarkable improvement with prone nursing, doctors here began to practice that in the ICUs.

Doctors also decided to keep patients under observation for longer time. “Initially, we gave them anticoagulants to reduce thrombosis (blood clots in vessels) on admission and many responded well. But soon after we shifted them to the ward, some patients collapsed. That’s when we discovered happy hypoxia. Their oxygen saturation was dangerously low. Before we could do anything many just died,” said a doctor at Stanley Medical College Hospital, Chennai.

Now, hospitals use pulse oxymeters, verify chest x-rays before they send patients to step down wards or advise them home quarantine, he said.

More than anything else, there is an increase in the number of patients coming forward for testing and isolation, says former director of public health Dr K Kolandaisamy. “More people seek medical assistance even for normal fever and cold,” he said.

AK Ravikumar, state secretary of Indian Medical Association (IMA), said better testing rate has also helped in early identification of patients including asymptomatic ones so that treatment can be started soon.

Percentage of people who spent more days in ICUs before they died is up