Open AccessExcess Mortality in a Nephrology Clinic during First Months of Coronavirus Disease-19 Pandemic: A Pragmatic Approach
Author(s) -
Lada Trajceska,
Aleksandra Canevska,
Nikola Gjorgjievski,
Mimoza Milenkova,
Adrijana Spasovska-Vasilevska,
Galina Severova-Andreevska,
Daniela Mladenovska,
Vladimir Pusevski,
Maja Kuzmanovska,
Elizabeta Janceska,
Golubinka Bosevska,
Irena Rambabova-Busljetik,
Gjulsen Selim,
Goce Spasovski
Publication year - 2020
Publication title -
open access macedonian journal of medical sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.288
H-Index - 17
ISSN - 1857-9655
DOI - 10.3889/oamjms.2020.5508
Subject(s) - medicine , excess mortality , mortality rate , pandemic , population , covid-19 , demography , referral , emergency medicine , nephrology , disease , pediatrics , infectious disease (medical specialty) , family medicine , environmental health , sociology
BACKGROUND: Excess mortality is defined as mortality above what would be expected based on the non-crisis mortality rate in the population of interest.
AIM: In this study, we aimed to access weather the coronavirus disease (COVID)-19 pandemic had impact on the in-hospital mortality during the first 6 months of the year and compare it with the data from the previous years.
METHODS: A retroprospective study was conducted at the University Clinic of Nephrology Skopje, Republic of Macedonia. In-hospital mortality rates were calculated for the first half of the year (01.01–30.06) from 2015 until 2020, as monthly number of dead patients divided by the number of non-elective hospitalized patents in the same period. The excess mortality rate (p-score) was calculated as ratio or percentage of excess deaths relative to expected average deaths: (Observed mortality rate–expected average death rate)/expected average death rate *100%.
RESULTS: The expected (average) overall death mortality rate for the period 2015–2019 was 8.9% and for 2020 was 15.3%. The calculated overall excess mortality in 2020 was 72% (pscore 0.72).
CONCLUSION: In this pragmatic study, we have provided clear evidence of high excess mortality at our nephrology clinic during the 1st months of the COVID-19 pandemic. The delayed referral of patients due to the patient and health care system-related factors might partially explain the excess mortality during pandemic crises. Further analysis is needed to estimate unrecognized probable COVID-19 deaths.