DETERMINANTS OF IN-HOSPITAL MORTALITY: A SCOPING REVIEW OF PATIENTAND HOSPITAL-RELATED FACTORS
Main Article Content
Keywords:
Mortality, Patient safety, Hospital QualityAbstract
related factors associated with mortality during hospitalization. The review followed Joanna Briggs Institute methodology and PRISMA-ScR using the Population–Concept–Context framework. ScienceDirect, ProQuest, and Google Scholar were searched for English-language studies published between 2016 and 2026. Of 446 records identified, 10 studies met the eligibility criteria. Frequently reported patient-related factors included older age, comorbidity, disease severity, acute physiological instability, infection, organ dysfunction, postoperative complications, obesity, and medication-related risks. Hospital-related factors included prolonged emergency department stay, staffed-bed availability, critical care capacity, emergency surgery, and delayed escalation of care. In-hospital mortality is shaped by the interaction between patient vulnerability and the hospital’s capacity to provide timely and effective care.
ABSTRAK
Mortalitas rawat inap merupakan indikator penting mutu pelayanan dan keselamatan pasien. Scoping review ini bertujuan memetakan faktor pasien dan faktor rumah sakit yang berkaitan dengan mortalitas selama perawatan. Kajian mengikuti metodologi Joanna Briggs Institute dan PRISMA-ScR dengan kerangka Population–Concept–Context. Penelusuran dilakukan melalui ScienceDirect, ProQuest, dan Google Scholar untuk artikel berbahasa Inggris terbitan 2016–2026. Dari 446 artikel yang ditemukan, 10 studi memenuhi kriteria. Faktor pasien yang sering dilaporkan meliputi usia lanjut, komorbiditas, keparahan penyakit, gangguan fisiologis akut, infeksi, disfungsi organ, komplikasi pascaoperasi, obesitas, dan risiko terkait obat. Faktor rumah sakit meliputi lama tinggal di instalasi gawat darurat, ketersediaan tempat tidur, kapasitas perawatan intensif,
operasi emergensi, dan keterlambatan eskalasi pelayanan. Mortalitas rawat inap dipengaruhi oleh interaksi antara kerentanan pasien dan kemampuan rumah sakit memberikan pelayanan yang tepat waktu dan efektif.
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References
1. Anggryani F, Santoso A, Wicaksono T, Sasongko BAB. Analisis Tingkat Mortalitas pada Laporan Tahunan di Rumah Sakit Katolik Budi Rahayu Blitar. Journal of Information Systems for Public Health. 2021;6(3).
2. Nursoffa I, Kosasih. Analisis Komprehensif Length Of Stay dan Angka Mortalitas Pasien Terhadap Kualitas Pelayanan di Rumah Sakit: Sytematic Literature Review. JURNAL LOCUS: Penelitian & Pengabdian. 2025;4.
3. English M, Mwaniki P, Julius T, et al. Hospital Mortality - A Neglected but Rich Source of Information Supporting The Transition to Higher Quality Health Systems in Low and Middle Income Countries. BMC Med. 2018;16(1). doi:10.1186/s12916-018-1024-8
4. Naik H, Murray TM, Khan M, et al. Population-Based Trends in Complexity of Hospital Inpatients. JAMA Intern Med. 2024;184(2):183-192. doi:10.1001/jamainternmed.2023.7410
5. Porcel-Gálvez AM, Barrientos-Trigo S, Gil-García E, Aguilera-Castillo O, Pérez-Fernández AJ, 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(21):7951.
6. Lee KS, Min HS, Moon JY, et al. Patient and Hospital Characteristics Predict Prolonged Emergency Department Length of Stay and In-hospital Mortality: A Nationwide Analysis in Korea. BMC Emerg Med. 2022;22(1). doi:10.1186 s12873-022-00745-y
7. Adamuz J, Juve-Udina ME, Gonzalez-Samartino M, et al. Care Complexity Individual Factors Associated with Adverse Events and In-hospital Mortality. PLoS One. 2020;15(7 July). doi:10.1371/journal.pone.0236370
8. Lentsck MH, de Oliveira RR, Corona LP, Mathias TA de F. Risk Factors for Death of Trauma Patients Admitted to An Intensive Care Unit. Rev Lat Am Enfermagem. 2020;28. doi:10.1590/1518-8345.3482.3236
9. Palaiodimos L, Kokkinidis DG, Li W, et al. Severe Obesity, Increasing Age and Male Sex are Independently Associated with Worse In-hospital Outcomes, and Higher In-hospital Mortality, in A Cohort of Patients with COVID-19 in The Bronx, New York. Metabolism. 2020;108:154262.
10. Akolbire D, Akolbire DA, Nkrumah-Ababio N, Prempeh J, Osei-Poku G, Thomas AN. Clinical and Socioeconomic Predictors of In-Hospital Mortality in Acute Pulmonary Embolism: A CrossSectional Study Using the US National Inpatient Sample Data. Res Pract Thromb Haemost. Published online May 2026:106652. doi:10.1016/j.rpth.2026.106652
11. Samsudin N, Ibrahim R, Aizuddin AN, Hamid SN. Determinants of In-Hospital Mortality Among Type 2 Diabetes Mellitus-Related Admissions in a Tertiary Teaching Hospital. Healthcare (Switzerland). 2026;14(3). doi:10.3390/healthcare14030347
12. Raya Ortega L, Martínez Tapias J, Ferreras Fernández MJ, et al. In-Hospital Mortality and Costs of Added Morbidity in Heart Failure Patients at a University Hospital: A Retrospective CrossSectional Study. J Cardiovasc Dev Dis. 2025;12(5). doi:10.3390/jcdd12050185
13. Ma CM, Liu Q, Li ML, et al. The effects of Type 2 Diabetes and Postoperative Pneumonia on the Mortality in Inpatients with Surgery. Diabetes, Metabolic Syndrome and Obesity. 2019;12:2507-2513. doi:10.2147/DMSO.S232039
14. Hădăreanu CD, Hădăreanu DR, Stoiculescu FM, et al. Predictors of Prolonged Intensive Care Unit Stay and In-Hospital Mortality Following Cardiac Surgery: An Integrated Analysis from the PROCARD-ATI Study. J Clin Med. 2025;14(8). doi:10.3390/jcm14082747
15. Osinaike B, Ayandipo O, Onyeka T, et al. Nigerian Surgical Outcomes – Report of A 7-day Prospective Cohort Study and External Validation of The African Surgical Outcomes Study Surgical Risk Calculator. International Journal of Surgery. 2019;68:148-156. doi:10.1016/j.ijsu.2019.06.003
16. Alrifady BB, Khan AH, Zawiah M, Elkarimi AA, Sulaiman SA, Elreyani NE. Assessing Drug-Drug Interactions- Prevalence, Predictors, and Their Impact on In-hospital Mortality in Hospitalised Haemodialysis Patients. Pharmacia. 2024;71. doi:10.3897/pharmacia.71.e134774
17. Lauque D, Khalemsky A, Boudi Z, et al. Length-of-Stay in the Emergency Department and InHospital Mortality: A Systematic Review and Meta-Analysis. J Clin Med. MDPI. 2023;12(1). doi:10.3390/jcm12010032
18. Habib H, Sudaryo MK. Association Between the Emergency Department Length of Stay and inHospital Mortality: A Retrospective Cohort Study. Open Access Emergency Medicine. 2023;15:313-323. doi:10.2147/OAEM.S415971
19. Boudi Z, Lauque D, Alsabri M, et al. Association Between Boarding in The Emergency Department and In-hospital Mortality: A Systematic Review. PLoS One. Public Library of Science. 2020;15(4). doi:10.1371/journal.pone.0231253
20. McGaughey J, Fergusson DA, Van Bogaert P, Rose L. Early Warning Systems and Rapid Response Systems for The Prevention of Patient Deterioration on Acute Adult Hospital Wards. Cochrane Database of Systematic Reviews. John Wiley and Sons Ltd. 2021;2021(11). doi:10.1002/14651858.CD005529.pub3
21. Ye C, Wang O, Liu M, et al. A real-time early warning system for monitoring inpatient mortality risk: prospective study using electronic medical record data. J Med Internet Res. 2019;21(7):e13719.
22. Griffiths P, Ball J, Murrells T, Jones S, Rafferty AM. Registered Nurse, Healthcare Support Worker, Medical Staffing Levels and Mortality in English Hospital Trusts: A Cross-sectional Study. BMJ Open. 2016;6(2):e008751.
23. Darmawan ES, Permanasari VY, Nisrina LV, Kusuma D, Hasibuan SR, Widyasanti N. Behind the Hospital Ward: In-Hospital Mortality of Type 2 Diabetes Mellitus Patients in Indonesia (Analysis of National Health Insurance Claim Sample Data). Int J Environ Res Public Health. 2024;21(5). doi:10.3390/ijerph21050581
24. Rosero EB, Romito BT, Joshi GP. Failure to rescue: A quality indicator for postoperative care. Best Pract Res Clin Anaesthesiol. 2021;35(4):575-589. doi:10.1016/J.BPA.2020.09.003
25. Mohr NM, Wessman BT, Bassin B, et al. Boarding of Critically Ill Patients in the Emergency Department. Crit Care Med. 2020;48(8):1180-1187. doi:10.1097/CCM.0000000000004385
26. Lee YS, Choi JW, Park YH, et al. Evaluation of the efficacy of the National Early Warning Score in predicting in-hospital mortality via the risk stratification. J Crit Care. 2018;47:222-226. doi:10.1016/J.JCRC.2018.07.011
27. Gerry S, Bonnici T, Birks J, et al. Early warning scores for detecting deterioration in adult hospital patients: systematic review and critical appraisal of methodology. BMJ. 2020;369(3). doi:10.1136/BMJ.M1501
