Causes of Mortality on a University Hospital Neurology Service

BACKGROUND: The mortality rate for all patients cared for by inpatient neurology services has not been described. METHODS: Quality assurance case discussions of all patients (n = 6012) admitted to a neurology service from 1996 to 2003 were reviewed to determine frequency and causes of mortality. All cases of mortality were reviewed in detail. RESULTS: The majority of patients (98%) survived their admission; 118 patients died. In 95/118 cases, care had been withdrawn at the time of death. In 11 cases, adverse events occurred during the patients' hospital stay and may have impacted outcome. Few patients (18%) had clear advance directives. CONCLUSION: Most mortality in this acute care neurology setting occurs in the course of stroke, epilepsy, or complicated tumor management and is managed through withdrawal of care with family participation.