Abstract

The authors performed a review on the records of 64 cases who lied within 48 hours after admission to the medical ward, department of interal medicine, National Medical Center, from February 1979 to September 1983. We tried in this analysis to seek the preadmission health status of the patients, the contributing factors to the early death and the problems related with the future critical care. Thirty one patients had limitingor advanced un-derlying diseases with organ failure such as liver cirrhosis, congestive heart failure and malignancy. Considerable portion of the subject presented mental impairment and dyspnea as their chief complaints on admission. Azotemia was found in 19 of 23 patients with available data. Fourteen of 17 patients with available data showed high anion gap metabolic aido-sis. Mechananical ventilation had to be performed in 23 patients and dopamine had to be infused in 20 patients. Major immediate causes of death were sepsis, respiratory failure, arrhythmia, and hepatic failure. The predominent pathophysiologid factor of their early death was considered as the interaction among underlying diseases, delayed admission, acute aggra-vating factors, severe infection and multiple organ failure.