Pattern, duration of stay, and outcomes of medical admissions: a report from teaching community hospital in Assir region, Saudi Arabia

Trends and outcomes of cardiovascular disease admissions in Lagos, Nigeria: a 16-year review

BACKGROUND

Cardiovascular disease (CVD)-related admissions are on the increase in Nigeria and the rest of Africa. This study was carried out to highlight the burden, patterns and outcomes of CVD admissions in a tertiary hospital over a 16-year period in Lagos, Nigeria.

METHODS

Admissions records of patients admitted into the medical wards within the study period (January 2002 to December 2017) were reviewed and relevant information pertaining to the study objectives was retrieved for analysis.

RESULTS

There were a total of 21 369 medical admissions and 4 456 (20.8%) CVD-related admissions. A total of 3 582 medical deaths were recorded and 1 090 (30.4%) CVD-related deaths. The median age of the patients was 56.6 (46.0-68.0) years and 51.4% of these were males. Stroke, heart failure, hypertensive disease and acute coronary syndrome constituted 51.2, 36.2, 11.3 and 1.6% of all CVD admissions, respectively. There was a cumulative increase in the number of CVD admissions and deaths (p < 0.001, respectively) during the period under review.

CONCLUSIONS

CVD admissions are not only common in Nigeria, but there was also a temporal exponential increase in both the admission and death rates, most likely reflecting the epidemiological transition in Nigeria.

Disease patterns and clinical outcomes of medical admissions at a tertiary hospital in Northern Tanzania: A retrospective observational study

Background and Aims

The burden of noncommunicable diseases is increasing in developing countries and in settings with an existing communicable burden. The study aim was to identify the disease pattern, length of stay, and clinical outcome of medical admissions.

Methods

A retrospective observational study of patients admitted to medical wards between 1st July 2019 and 30th June 2020, excluding those admitted for chemotherapy. The outcome measures were the pattern of disease, length of stay, and clinical outcome.

Results

A total of 3930 patients were analyzed. A total of 53.5% were males, and 42.9% were aged 51-75 years, with a median age of 57 years (IQR 41-71). A total of 41.3% had health insurance, 21.7% died, and the median length of stay was 6 days (IQR 4-9). Cardiovascular diseases were the most common diagnosis (26.8%) on admission and cause of death (27.9%). The common causes of death were stroke (15.1%), chronic kidney disease (11.1%), and heart failure (9.0%). Noninsured patients had a high mortality risk (odds ratios [OR] 1.67, 95% confidence interval [CI] 1.42-1.96), which was also seen among patients aged more than 75 years (OR 1.3, 95% CI 1.08-1.57), patients with communicable diseases (OR 1.44, 95% CI 1.23-1.68), and weekend admissions (OR 1.29, 95% CI 1.08-1.55). The 72-h admission window is critical due to a very high mortality risk (OR 3.03, 95% CI 2.58-3.56).

Conclusion

Cardiovascular diseases are the leading cause of hospital admissions and deaths in a tertiary hospital in Northern Tanzania. Lifestyle modification, health education, and community resources are needed to combat the growing burden of cardiovascular and renal disease.

Hypoglycemic Risk Factors Among Hospitalized Patients with Type 2 Diabetes Mellitus at King Abdulaziz Medical City, Jeddah

Background Hypoglycemia is a pathological condition in which the serum glucose level measures less than 3.0 mmol/L. It is a well-known complication in patients with diabetes mellitus. Age, body weight, gender, insulin usage, nutritional therapy, body mass index (BMI), the presence of diabetes complications, intensive care unit admission, and infection were reported as possible risk factors that may increase the risk of hypoglycemia. Therefore, this study aimed to analyze predisposing factors for hypoglycemia among hospitalized patients with type 2 diabetes in King Abdulaziz Medical City. Method This is a retrospective, case-control study design. The study included 326 hospitalized patients with type 2 diabetes; 152 experienced hypoglycemia (blood glucose <3.9) at least once during hospitalization and have been compared to 174 in the non-hypoglycemic group (blood glucose ≥3.9). Data were extracted from their electronic medical records (EMRs). Results This study reported that patients with lower BMI (28.80 ± 7 versus 31.20 ± 12.93) experienced hypoglycemia (P-value 0.044). Those hospitalized with infections or had acquired infections or required intensive care unit (ICU) admission during hospitalization had a higher risk to develop hypoglycemia (P-value 0.005, 0.003, and <0.001, respectively). Moreover, the use of multiple doses of insulin therapy or basal-plus insulin therapy was associated with a higher risk of hypoglycemia (P-value 0.012 and 0.028, respectively). Those on supplemental insulin were less likely to develop hypoglycemia (P-value <0.001). Patients on oral feeding had a lower chance of having a hypoglycemic attack (P-value 0.002) while those on tube feeding had double the odds (OR=2.37). Conclusions Infection, intensive care unit admission, lower body mass index, insulin regimen and nutritional therapy (enteral feeding and nothing-per-mouth (NPO)) were correlated with an elevated risk of having hypoglycemia in hospitalized patients with type 2 diabetes mellitus.