Medical Admissions in a Rural Teaching Hospital in Southern Nigeria: A Retrospective Review. https://doi.org/10.60787/NMJ-63-5-136
Main Article Content
Keywords
Medical admission, Morbidity, Mortality, Nigeria, communicable disease, non-communicable disease
Abstract
Background: Hospital-based morbidity and mortality records reflect the health status of host communities. This helps policymakers and industry actors plan and allocate resources for health services, research, training, and development. This study aimed to determine the pattern and outcome of medical admissions in a Nigerian teaching hospital.
Methodology: This was a three-year retrospective review from 2019 to 2021. Data on morbidity and mortality were extracted from ward registers. The relevant data was analysed using the IBM SPSS software. Tests were considered significant at p-values of less than 0.05.
Results: A total of 2544 patients were admitted during the study period. There were 1420 females (55.8%) and 1124 males (44.2%), and the majority (36.9%) of patients were middle-aged. The mean age was 53.81± 18.81 years, and the mean duration of hospital stay was 9.07 ± 8.41 days, with 97.2% of the patients spending less than 30 days on admission. Non-communicable diseases (70.6%) were the most common causes of admissions. The top disease-specific causes of admissions were diabetes mellitus with its complications (14.9%), renal failure (11.8%), heart failure (9.2%), hypertension and its emergencies (9.2%), stroke (7.8%) and tuberculosis (7.0%). Cardiology (15.5%), endocrinology (15.1%), nephrology (15.0%), pulmonology (14.8%), and neurology (13.3%) accounted for the majority (86.4%) of the admissions. The major causes of death were renal failure (16.2%), stroke (15.8%), diabetes mellitus and its complications (12.5%) and HIV/AIDS (8.7%). The majority (86.7%) of patients were discharged, 10.4% died, 2.2% were discharged against medical advice, and 0.7% were referred.
Conclusion: The study found an increased burden of non-communicable diseases relative to communicable diseases. Effective health education and promotion initiatives must be implemented to combat the impact of the increasing prevalence of these diseases.
References
2.Okunola OO, Akintunde AA, Akinwusi PO. Some emerging issues in medical admission pattern in the tropics. Niger J Clin Pract.2012; 15:51–4.
3.Maher D,Smeeth L, Sekajugo J. Health transition in Africa: Practical policy proposals for primary care. Bull World Health Organ.2010; 88:943–8.
4.Myint PK, MacLullich AMJ, Witham MD. The role of research training during higher medical education in the promotion ofacademic medicine in the UK. Postgrad Med J. 2006; 82:767–70.
5.Marszalek J, Villiers P De. Morbidity profile of admissions to GF Jooste Hospital, Manenberg, Cape Town. S Afr Fam Pract.2006; 48:5-15e.
6.Akoria OA, Unuigbe EI. A 6-month review of medical admissions in a Nigerian Teaching Hospital. Int J Health Res.2009; 2:125–30.
7.Olarinde OJ, Olatunji OY. Pattern of deaths in medical wards of a rurally situated tertiary health institution, Ido-Ekiti, Nigeria. Niger JClin Pract.2014;17:237–40.
8.Kalyesubula R, Mutyaba I, Rabin T, Andia-Biraro I, Alupo P, Kimuli I, et al. Trends of admissions and case fatality rates among medical in-patients at a tertiary hospital in Uganda; A four-year retrospective study. PLoSOne.2019;14:e0216060.
9.Al-Ghamdi MA, Bin Abdulhak AA. Pattern,duration of stay, and outcomes of medical admissions: a report from teaching community hospital in Assir region, Saudi Arabia. JCommunity Hosp Intern Med Perspect. 2018;8:53–6.
10.Ali E, Woldie M. Reasons and Outcomes of Admissions to theMedical Wards of Jimma University Specialized Hospital, Southwest Ethiopia. Ethiop J Health Sci.2010; 20:113–20.
11.Ogun SA, Adelowo OO, Familoni OB, Jaiyesimi AE, Fakoya EA. Pattern and outcome of medical admissions at the Ogun State University Teaching Hospital, Sagamu--a three-year review. West Afr J Med. 2000; 19:304–8.
12.Ike SO. The pattern of admissions into the medical wards of the university of Nigeria teaching Hospital, Enugu (2). Niger J ClinPract. 2008;11:185–92.
13.Ojobi JE, Onuh JA, Odoh G, Gomerep SS, Ogiator MO. Pattern of medical admissions in a tertiary health centre in Makurdi , North Central Nigeria : A one year review. Highl MedResJ.2014;14:2–8.
14.Odenigbo CU, Oguejiofor OC. Pattern of medical admissions at the Federal Medical Centre, Asaba-a two-year review. Niger J ClinPract.2009;12:396–7.
15.Ezeala-Adikaibe B, Aneke E, Aneke C, Ezeala-Adikaibe N, Mbadiwe M, Chime P, et al. Pattern of medical admissions at Enugu State University of Science and Technology Teaching Hospital: A 5-year review.Ann MedHealth Sci Res.2014;4:426–31.
16.Njoku P, Enomina M, Obehighe E, Mbah I, Okoro E, Essen M, et al. Pattern of non-communicable diseases seen in a tertiary hospital in Keffi, North Central Nigeria. NigerJ Cardiol.2019;16:60–5.
17.Nkpozi MO, Nwanke RI, Uzor EI, Ubani-Ukoma BC, Ugwu ET. Pattern and outcome of medical admissions in a teaching hospital in the southeast region of Nigeria. Innov J MedHealth Sci. 2020;10:856–61.
18.Adeoti AO, Ajayi EA, Ajayi AO, Dada SA, Fadare JO, Akolawole M, et al. Pattern and Outcome of Medical Admissions in Ekiti State University Teaching Hospital, Ado-Ekiti-A 5 Year Review. Am J Med Med Sci. 2015; 5:92–8.
19.Unachukwu CN, Agomuoh DI, Alasia DD. Pattern of non-communicable diseases among medical admissions in Port Harcourt, Nigeria. Niger J Clin Pract.2008;11:14–7.
20.Hawkes S, Buse K. Gender and global health: Evidence, policy, and inconvenient truths. Lancet. 2013;381:1783–7.
21.Laufer-Perl M, Havakuk O, Shacham Y, Steinvil A, Letourneau-Shesaf S, Chorin E, et al. Sex-based differences in prevalence and clinical presentation among pericarditis and myopericarditis patients. Am. J. Emerg. Med.2017; 35:201–5.
22.Hu Y, Shan Y, Du Q, Ding Y, Shen C, WangS, et al. Gender and Socioeconomic Disparities in Global Burden of Epilepsy: An Analysis of Time Trends From 1990 to 2017. Front.Neurol. 2021;12: 643450.
23.Nissim L, Lieber SB, Naffaa ME, Fowler ML, Shmerling RH, Paz Z. The impact of gender on the clinical presentation, management, and surgical outcomes of patients with native-joint septic arthritis. J Eval Clin. Pract. 2021; 27:371–6.
24.Ogunmola OJ, Oladosu OY. Pattern and outcome of admissions in the medical wards of a tertiary health centre in a rural community of Ekiti state. Ann Afr Med.2014; 13:195–203.
25.Eze CO, Agu CE, Kalu UA, Maduanusi CA, Nwali ST, Igwenyi C. Pattern of medical admissions in a tertiary health centre in Abakaliki South-East Nigeria. J Biol AgricHealthc. 2013;3:90–4.
26.Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006; 3:e442.
27.Osarenkhoe J, Omoruyi L, Imarhiagbe L, Adebayo O, Freeman O. Pattern and outcome of medical admissions in a Nigerian rural teaching hospital (2009-2012). Ann Trop MedPublic Health. 2014;7:171–6.
28.Egbi OG. Morbidity patterns among medical admissions at Niger Delta University Teaching Hospital, Bayelsa State, Nigeria. Ann ClinBiomedRes. 2021;2:145.
29.Agomuoh DI, Unachukwu CN. Pattern of Diseases among Medical Admissions in Port Harcourt, Nigeria. Niger Med Pract. 2007; 51:45–50.
30.International Diabetes Federation. Diabetes inAfrica. Diabetes Atlas Fact sheet 2021; [cited August 22, 2022]. Available from: https://diabetesatlas.org/idfawp/resource-files/2022/01/IDF-Atlas-Factsheet-2021_AFR.pdf.
31.Uloko AE, Musa BM, Ramalan MA, Gezawa ID, Puepet FH, Uloko AT, et al. Prevalence and Risk Factors for Diabetes Mellitus in Nigeria: A Systematic Review and Meta-Analysis. Diabetes Ther.2018;9:1307–16.
32.Stanifer JW, Jing B, Tolan S, Helmke N, Mukerjee R, Naicker S, et al. The epidemiology of chronic kidney disease in sub-Saharan Africa: A systematic review and meta-analysis. Lancet Glob. Health.2014;2:e174–81.
33.Corbett EL, Watt CJ, Walker N, Maher D, Williams BG, Raviglione MC, et al. The growing burden of tuberculosis: Global trends and interactions with the HIV epidemic. ArchIntern Med.2003;163:1009–21.
34.Hadiza S. Mortality patterns in the Medical Wards of Murtala Muhammad Specialist Hospital, Kano, Nigeria. Niger J Basic Clin Sci. 2018; 15:73-6.
35.Chijioke A, Kolo PM. Mortality pattern at the adult medical wards of a teaching hospital in sub-Saharan Africa. Int J Trop Med. 2009; 4:27–31.
36.Papadopoulos IN, Papaefthymiou M, Roumeliotis L, Panagopoulos VG, Stefanidou A, Kostaki A. Status and perspectives of hospital mortality in a public urban Hellenic hospital, based on a five-year review. BMCPublic Health2008;8:28.
37.Lopez AD, Mathers CD, Ezzati M, Jamison DT, Murray CJ. Globaland regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet.2006; 367:1747–57.
38.Yong TY, Fok JS, Hakendorf P, Ben-Tovim D, Thompson CH, Li JY. Characteristics and outcomes of discharges against medical advice among hospitalised patients. Intern Med J.2013; 43:798–802.
39.Menachemi N, Collum TH. Benefits and drawbacks of electronic health record systems. Risk Manag Healthc Policy. 2011;4:47–55.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
This is an open-access journal and articles are distributed under the terms of the Creative Commons Attribution Non-Commercial Share-Alike License 4.0. This licence allows users to download and share, remix, tweak and build upon the article for non-commercial purposes, so long as the original authorship is acknowledged and the new creations are licensed under identical terms.