Surgical, Obstetric, and Anesthetic Mortality Measurement at a Ugandan Secondary Referral Hospital Journal Articles uri icon

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  • BACKGROUND: The 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. METHODS: We 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. RESULTS: There 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. CONCLUSIONS: The combination of perinatal, maternal, trauma, and perioperative mortality metrics captured most deaths documented at a Ugandan referral hospital.


  • Firth, Paul G
  • Mushagara, Rhina
  • Musinguzi, Nicholas
  • Liu, Charles
  • Boatin, Adeline A
  • Mugabi, Walter
  • Kayaga, Dorothy
  • Naturinda, Phionah
  • Twesigye, Deus
  • Sanyu, Frank
  • Mugyenyi, Godfrey
  • Ngonzi, Joseph
  • Ttendo, Stephen

publication date

  • December 2021

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