Background A 2014 paper by Clark et al found that 28.8% of hospital inpatients in Scotland died within 12 months. In the years pre, during and post Covid-19 we wished to repeat this at a local level to see if there had been any impact of the pandemic on death rates within our inpatient population. Knowing this information may have an impact on hospital policies, realistic medicine implementation and palliative care service development.

Aim To establish the incidence of death during index admission and within the following 12 months of a cohort of NHS Ayrshire and Arran acute hospital inpatients on a given census date over a three year period 2019–2022.

Method A retrospective cohort study of all inpatients at University Hospital Crosshouse (UHC) and University Hospital Ayr (UHA), excluding paediatrics and obstetrics, on the date 31st March 2019, 2020 and 2021 was performed. Data was collected by Business Intelligence and analysed by researchers.

Results 720, 331 and 685 inpatients were identified on the given census date on all three years. End points were death at 7 days, 30 days, 3 months, 6 months, 9 months and 1 year. Rates of death at all end points were lower in 2019 and highest in 2020. The incidence of death at one year was 28.6% in 2019, 38% in 2020 and 31.2% in 2021. The incidence of death during index admission was 7.5% (2019), 14% (2020) and 9.2% (2021).

Conclusion Our results show that during the Covid-19 pandemic death rates during index admission and at all follow up points rose. They have now reduced but still remain higher than pre-pandemic levels. This data should assist in realistic medicine strategies as well as palliative care service development.