Rise in deaths after respiratory diagnoses in Irish hospitals 'directly attributed' to Covid-19

National Audit of Hospital Mortality found there was a rise in the mortality rate in those respiratory diagnoses, particularly for pneumonia. This was directly linked to the arrival of the pandemic in Ireland in early 2020. File picture

While there was a reduction in the number of cases admitted for in-hospital treatment in acute hospitals in 2020 when compared with 2019, Covid-19 contributed to a rising mortality rate for those with respiratory diagnoses, according to a new report.

The rise in the crude mortality rate — which measures the total number of deaths in a specific setting, in this case acute hospitals — was “directly attributed to Covid-19”, according to the National Office of Clinical Audit.

The sixth edition of its National Audit of Hospital Mortality (NAHM) found there was a rise in the mortality rate in those respiratory diagnoses, particularly for pneumonia. This was directly linked to the arrival of the pandemic in Ireland in early 2020.

On the other hand, it said the reduction in the number of cases admitted for treatment in acute hospitals was “anecdotally found to be due to people’s reluctance to go to a hospital for fear that they would contract [Covid-19] while there”.

The NAHM report for 2020 presents standardised mortality ratios for six medical conditions: heart attack, heart failure, ischaemic stroke, haemorrhagic stroke, chronic obstructive pulmonary disease (COPD), and pneumonia.

The number of pneumonia deaths recorded rose from 103 per 1,000 admissions in 2019 to 131 deaths per 1,000 admissions reported in 2020.

In 19.4% of pneumonia cases, Covid-19 had been either been laboratory-confirmed or clinically diagnosed.

Between March 2020 and March 2021, 16,831 cases of people in hospital were either laboratory-confirmed positive for Covid-19 or clinically diagnosed. Of these, 2,588 (15%) died, the report stated.

The median length of hospital stay for someone who died with Covid-19 was 14 days, and eight days for those who survived.

The crude mortality rate for COPD rose slightly in 2020 (from 37 per 1,000 admissions to 38 per 1,000 admissions) but the report noted a downward trend had been recorded between 2011 and 2018.

Further downward trends could be seen for in-hospitality mortality for acute myocardial infarction or heart attack. 

In 2011, 69 deaths were recorded per 1,000 admissions. This fell to 47 per 1,000 admissions by 2019. It increased slightly to 49 deaths per 1,000 in 2020.

There were further reductions since 2011 in mortality rates from heart failure, ischaemic stroke and haemorrhagic stroke in Irish hospitals.

The report concluded: “Levels of in-hospital mortality throughout 2020 were lower than anyone had dared to expect when first faced with the Covid-19 pandemic that spread throughout communities, taking hold of our loved ones.” 

NAHM clinical lead Bridget Egan said it was “reassuring that there have been no hospitals with mortality outcomes outside of expected ranges in the 2020 data, despite the number of cases with Covid-19 in hospitals”.