Mortality among Diabetes In-Patients in Port-Harcourt, Nigeria

Unachukwu, C N; Uchenna, DI; Young, Ekenechukwu

doi:10.4314/ajem.v7i1.57567

Cited by 16 publications

(18 citation statements)

References 10 publications

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“…There was a high case fatality rate (12.6 while Unachukwu et al [38] reported an overall case fatality for diabetes of 17.2 %; the most common cause of death being acute complications. The mortality rate in our study was independent of the underlying pathological class of the ulcer.…”

Section: Discussionmentioning

confidence: 96%

Outcome of diabetic foot ulcer admissions at the medical wards of University of Nigeria Teaching Hospital Enugu, Nigeria

Young

Anyim

Onyenekwe

et al. 2015

Int J Diabetes Dev Ctries

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Diabetic foot ulcer (DFU) is associated with a high rate of morbidity, prolonged hospital stay, and serious complications including limb amputation. The objective of this study was to determine the outcome of DFU among medical inpatients in the University of Nigeria Teaching Hospital Enugu, Nigeria. Data from case records of diabetes-related admissions into the medical wards of the University of Nigeria Teaching Hospital Enugu (UNTH) between January 2009 and December 2012 were analyzed. Statistical analysis was done using SPSS v17. Out of 726 diabetes mellitus (DM)-related admissions (59.1 % males, 40.9 % females), DFU accounted for 119 (16.4 %), of which 65.5 % were males and 34.5 % were females. The mean duration of diabetes in DFU patients was 7.2±5.8 years, while the median (interquartile range) duration of the ulcer before the presentation was 24 (14-60) days. The mean age of patients with DFU was 55.2 ± 13.2 years, while the duration of hospital stay ranged from 2 to 98 days, median (interquartile range (IQR)) of 16 (9.8-30.3)days. Out of the 119 DFU admissions, 88 (73.9 %) were discharged, 15 (12.6 %) died, while 16 (13.5 %) discharged themselves against medical advice (DAMA). Of those who were discharged, about 75 % were discharged with nonhealed ulcers either for outpatient care or to surgical units. The most common Wagner grade of ulcer was grade 3 (41.5 %). Risk factors for ulceration were peripheral vascular disease in 47.1 % and peripheral neuropathy in 57.6 %.Mortality due to DFU accounted for 10.6 % of all diabetes mortality. Diabetic foot ulcer was a common reason for admission and characterized by late presentation and advanced ulcer stage. Diabetes foot ulcers admitted and managed in the medical wards were associated with poor outcome.

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Section: Discussionmentioning

confidence: 96%

Outcome of diabetic foot ulcer admissions at the medical wards of University of Nigeria Teaching Hospital Enugu, Nigeria

Young

Anyim

Onyenekwe

et al. 2015

Int J Diabetes Dev Ctries

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“…The increased need for insulin combined with food insecurity presents a challenge in managing insulin use, as patients are at a heightened risk for hypoglycaemia in the outpatient setting owing to a lack of food after injecting. Blood glucose monitoring is not a commonly used method of care in resource‐constrained settings because of the expense of purchasing a glucometer and test strips, which also increases the risk of hypoglycaemia . A challenge is presented for clinicians, who are trying to manage each patient's condition through medication and lifestyle modifications, when there is the larger underlying problem of somewhat unpredictable access to food.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of food insecurity in patients with diabetes in western Kenya

et al. 2013

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Despite the widely recognized contribution of caloric over-nutrition to the development of diabetes, this study highlights the high prevalence of food insecurity amongst patients with diabetes in rural, resource-constrained settings. Other factors, such as the lower prevalence of obesity, poor glucose control, challenges in the use of insulin because of the risk of hypoglycaemia, and varying subtypes of diabetes in this population, point to the need for additional research in understanding the aetiology, pathophysiology and optimum management of this condition, as well as understanding the effects of enhancing food security.

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“…The mortality rate of 15.9% in the diabetics is similar to previous reports from other centers in Nigeria, which ranges from 8.8% -17.2%. 36,37 Ndububa and Erhabor 37 noted that the high mortality may have been due to chronic default from clinic, as well as ignorance about diabetic symptoms. Studies in Cameroon and Tunisia have shown limited knowledge about diabetes in patients suffering from the disease.…”

Section: Pulmonarymentioning

confidence: 99%

“…This is different from the reports from other centers in Nigeria where more male deaths were reported in diabetics. 36,37 The reason(s) for this is/ are unclear. However, we believe it may be related to the difficulties that females face in accessing health services promptly.…”

Section: Pulmonarymentioning

confidence: 99%

Diabetes Mellitus

Hafeez

Rehman

et al. 2018

TPMJ

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… Background: Diabetes mellitus is associated with significant morbidity and mortality worldwide and Pakistan is no exception. Objectives: To determine the morbidity and mortality in patients admitted with Diabetes Mellitus in a teaching hospital of Pakistan, through retrospective analysis of admission and patient file records. Study Design: Retrospectively analyzed. Setting: Independent University Hospital, a Teaching Hospital, Faisalabad. Period: 1 st January 2016 to 31 st December 2017. Patients and Methods: Data included age, gender, total numbers of admissions and those due to Diabetes Mellitus, the indications for admissions, presenting symptoms and method of diagnoses in diabetic patients, mortality rates and causes of death. Data obtained were analyzed using chi square. Results: Out of 10490 medical admissions, 5706 (54.4%) were males and 4784 (45.6%) females. Diabetes was detected in 1450 (13.8%) patients [810 (55.9%) males, 640 (44.13%) females]. The mean age of diabetic patients was 53.6+16.1 years (range 18 -94 years). Poor glycemic control (29%) and diabetic foot syndrome (23.4%) were the most common reasons for admission in diabetic cases. The overall mortality rate among medical admissions was 21.8%, with diabetes accounting for 6.7% deaths. Within the cohort of diabetic cases, mortality was 15.9%, with significantly higher mortality in those aged > 65 years (p < 0.05). The most common causes of death in diabetic cases were cerebrovascular disease and complications associated with the diabetic foot syndrome, accounting for 26.1% and 21.7% of deaths respectively; the least common causes of death in diabetic patients were pulmonary tuberculosis, meningitis, malaria and hepatic encephalopathy accounting for 4.4% of deaths. Conclusions: Cerebrovascular disease was the most frequent cause of mortality among admitted diabetic patients with diabetic foot syndrome (a preventable complication) as the second most frequent cause of mortality. Increased screening for diabetes mellitus morbidities in the clinic and community settings and adequate health education is required to reduce morbidity and mortality associated with diabetes mellitus.

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Mortality among Diabetes In-Patients in Port-Harcourt, Nigeria

Cited by 16 publications

References 10 publications

Outcome of diabetic foot ulcer admissions at the medical wards of University of Nigeria Teaching Hospital Enugu, Nigeria

Outcome of diabetic foot ulcer admissions at the medical wards of University of Nigeria Teaching Hospital Enugu, Nigeria

Prevalence of food insecurity in patients with diabetes in western Kenya

Diabetes Mellitus

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