Retrospective Epidemiological Profiling and Socio-Spatial Clustering of Brought-in-Dead Cases at Nchanga North General Hospital, Copperbelt Province, Zambia

Abstract Background Brought-in-Dead (BID) cases are individuals who die in the community without receiving immediate institutional medical attention, represent a significant, poorly understood public health challenge in Sub-Saharan Africa. Vital registration systems in these settings frequently fail to capture the demographic and socio-spatial determinants driving these out of hospital deaths. This study profiles the sociodemographic, clinical, and logistical determinants of BID occurrences at Nchanga North General Hospital in Chingola, Zambia, to identify systemic gaps in acute healthcare access. Methods A retrospective, cross-sectional descriptive study was conducted analyzing 554 consecutive BID cases recorded at Nchanga North General Hospital. Descriptive statistics, measures of central tendency, and bivariate cross-tabulations were compiled using IBM SPSS version 27.0. Geographic data points were stratified into urban housing densities based on local infrastructure parameters. Results The sample displayed a distinct bimodal mortality age distribution, with notable spikes among children under 5 years and older adults over 65 years (overall mean age: 47.1 years; median: 47.0 years). A major gender disparity was observed, with males accounting for 59.2% (n = 328) of the cohort; this gap was widest during productive adulthood (18–50 years). Spatial clustering analysis revealed that 64.6% (n = 358) of all cases originated from high-density, low-income neighbourhood (Kapisha, Chiwempala, Soweto, and Maiteneke). Retrospective clinical histories showed that while 95.1% (n = 527) of cases lacked documented comorbidities, 53.8% (n = 298) had visited a healthcare facility within the 3 months preceding death. Crucially, the postmortem autopsy rate was only 5.8% (n = 32), heavily biased toward medicolegal or traumatic arrivals managed by the Zambia Police Service 4.3% (n = 24) or organized community interventions 1.4% (n = 8). Conversely, 100% of the 86.3% (n = 478) of cases escorted by informal family networks were certified directly without pathological verification. Conclusion Community mortality in this cohort is driven by socio-economic vulnerabilities, geographical positioning, and critical missed opportunities for intervention during recent healthcare interactions. The low rate of autopsy utilization creates a significant blank spot in public health data, as natural community deaths bypass diagnostic verification entirely. Addressing this challenge requires strengthening community-level emergency medical services, establishing proactive monitoring for high-risk clinical outpatients, and expanding sentinel autopsy surveillance.