ArticleGhana medical journal2024
A 5-year retrospective outlook of cardiovascular risk(s), outcome and survival peculiarities among patients in medical confinement; a tropical perspective.
Article in Ghana medical journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: The study was designed to evaluate the distribution of cardiovascular risk(s), outcome modifiers and survival peculiarities among medically confined patients. Design: Evaluated admission and discharge summaries of medically confined patients retroactively over 5 years. Setting: Medical wards, UniOsun Teaching Hospital Osogbo, Osun State, Nigeria. Participants: Two thousand three hundred and forty (2340) male and female patients aged between 16 and 108 years. Main outcome measures: Admission pattern, cardiovascular risk distribution, outcome and survival peculiarities. Results: The mean age of the respondents was 53.2 (18.3) years with male preponderance (52.0%). Non-infectious diseases predominated as the principal causes of medical confinements (82.9%). Cerebrovascular accident (13.5%), acute decompensation of chronic kidney disease (11.6%) and type 2 diabetes mellitus (6.0%) were the prominent causes of morbidity. The median duration of confinement was 6.0 days. The overall crude mortality rate was 14.3%, with the highest case fatality rate (27.2%) among those with neurological morbidities. Clinical outcome was statistically influenced by age (p= 0.004), occupation (p=0.02), duration of confinement (p=0.002) and morbidity stratification into infectious/non-infectious aetiologies (p=0.040) on regression analysis. The number of medical sub-specialties involved (p < 0.001), specialty affected (p<0.001), and yearly pattern of hospitalisation (p< 0.001) had a statistical influence on Kaplan Meier's survival plots. Conclusion: Hospital confinements underlined by infection/non-infection-related medical causes exhibit variable outcomes. The loop-sided frequencies of its causes remain worrisome because of the unending challenges plaguing effective healthcare delivery in the tropics. Funding: None declared.
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