A 5-year retrospective outlook of cardiovascular risk(s), outcome and survival peculiarities among patients in medical confinement; a tropical perspective

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.