Michael McHale , 2025-08-28 06:00:00
Clinical audit found that, while mortality rates declined by 2023, they remained above pre-pandemic levels
The proportion of patients dying in hospital due to stroke or heart conditions fell significantly in the ten years to 2023, a new clinical audit has revealed.
However, overall mortality rates for these illnesses rose during the pandemic, and in 2023 remained above pre-Covid levels.
Between 2014 and 2023, the in-hospital mortality rate for patients with ischaemic stroke fell by 42 per cent, from 109 deaths per 1,000 discharges to 63 per 1,000. However, the number of hospital admissions for ischaemic stroke continues to rise, in line with Ireland’s ageing population.
Patients with haemorrhagic stroke saw a smaller decline of 12 per cent over that period. In 2023 the mortality rate was 266 deaths per 1,000 discharges, compared to 335 per 1,000 in 2017.
When it comes to heart attacks, the level of hospital deaths fell from 58 deaths per 1,000 discharges in 2014 to 47 per 1,000 in 2023. A similar drop was found among patients with heart failure – rates fell from 82 deaths per 1,000 discharges to 72 per 1,000 during the same period.
However, the audit found little improvement in mortality among patients with Chronic Obstructive Pulmonary Disease (COPD). The rate in 2023 stood at 38 deaths per 1,000 discharges, similar to the 2014 figure of 37 per 1,000.
The results were outlined in the National Audit of Hospital Mortality, published today by the National Office of Clinical Audit (NOCA).
“This report demonstrates how national audit continues to support improvements in patient care by providing robust, transparent data,” said NOCA clinical director Dr Brian Creedon.
“The inclusion of overall in-hospital mortality figures for all diagnoses gives us a broader picture than ever before.
“While it is encouraging to see progress for conditions like heart attack and stroke, there is still work to do to address variations, enhance data quality and develop our understanding of potential inequalities.”
The audit also presents trends in crude in-hospital mortality rates for all diagnoses. Following a gradual decline up to 2019, overall rates rose during the major Covid-19 waves in 2020 and 2021.
While mortality rates declined by 2023, they remained above pre-pandemic levels. The total number of hospital discharges has now returned to pre-pandemic levels.
The findings of the National Audit of Hospital Mortality report are a validation of the progress being made in Irish healthcare,” said HSE chief clinical officer Dr Colm Henry.
“The significant reductions in mortality for conditions like stroke and heart attack demonstrate a clear trend: that active, time-critical interventions are saving lives.
“While we are rightly encouraged by this progress, the report also serves as a crucial reminder of our responsibility to address health inequalities.
“We must continue to work with our partners to ensure that every patient, regardless of their background, has equitable access to the same high-quality care.
“This audit provides us with the essential data to drive further improvements and ensure our system is working for everyone.”