MORTALITY PATTERN IN MEDICAL WARDS IN CHUKWUEMEKA ODUMEGWU OJUKWU UNIVERSITY TEACHING HOSPITAL, AWKA, NIGERIA

Chinyelu Uchenna Ufoaroh, Ernest Ndukaife Anyabolu* Ifunanya Stellamaris Chinweuba, Innocent Chukwuemeka Okoye and Ifeoma Anne Njelita

ABSTRACT

Background and Objectives: Mortality pattern may reflect disease burden and influence medical policy formulation and implementation. This study sought to evaluate mortality and the influence of morbidity in patients in the medical wards in Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH), Awka Nigeria. Methodology: In this retrospective study on mortality in the medical wards, patients’ case files, admissions and discharge registers were pulled. Information on age, gender, diagnosis, race, clinical state, duration on admission, serum creatinine, serum urea, PCV, serum albumin, were obtained, and the data analyzed. Results: The admissions were 1583 and patients deaths 325(20.5%) comprised of 167 (54.2%) males and 158 (45.8%) females. Only 153 deaths had complete data with mean age of 54.58 ± 17.40 years; mean duration on admission 9.94 ± 13.20 days and 59.5% of deaths occurred in the first 7 days; 90 (58.8%) were 31-60years. Anemia was present in 64.8% of male deaths and 54.8% of female deaths. Mortality rate (MR) in males was 53.4% and 75.8% in females among those with azotemia. MR was 18.5% in those with hypoalbuminemia and 32.7% with unconsciousness. Patients’ diagnoses were: sepsis (44.4%), diabetes mellitus (23.5%), HIV (27.5%), hypertension (20.3%) and stroke (15.7%). In those with diabetes mellitus, MRs was high (58.3%) in the first 7 days, p<0.003. However, MRs in different durations of admissions did not vary significantly in those with Sepsis (p=0.062), HIV (p=0.374), HTN (p=0.880), stroke (p=0.141). There was some overlap in foci of infection. MRs varied in patients with Sepsis from different foci of infection and in different durations of admission. In diabetic ulcer patients, there was a significant difference in MRs influenced by duration of admission, with high MR of 56.3% in the first 7 days, p=0.024. MRs in other foci of infections did not vary significantly with varying durations of admission (Chest p=0.110, GIT p=0.223, Mouth p=0.409). In females with anemia, MR was high (47.8%) in the first 7 days, p=0.027. In male patients with anemia, MRs across different durations of admission did not differ significantly, p=0.568. In patients with azotemia, hypoalbuminemia, unconsciousness, there was no difference in MRs across different durations of admission. Conclusion: Mortality rate (20.5%) was high in this study with most (59.5%) occurring in the first week of admission, influenced by age, sepsis, azotemia, anemia, unconsciousness, and hypoalbuminemia. Common causes of death were sepsis, diabetes mellitus, HIV, hypertension, and stroke.

Keywords: High mortality rate, Duration of admission, Anemia, Azotemia, Hypoalbuminemia, Sepsis, Age, Awka, Nigeria.