Patient outcomes following after-hours and weekend admissions for cardiovascular disease in a tertiary hospital in Calabar, Nigeria

Abstract

SummaryBackgroundThere are various reports of higher mortality rates occurring after admissions over the weekend and during after-hours. This study aimed to determine if there was a difference in mortality rates occurring during the weekend and after-hours among cardiovascular admissions in a tertiary hospital in Nigeria.MethodsA review of cardiovascular admissions (including stroke) was carried out at the University of Calabar Teaching Hospital in Nigeria from January 2010 to December 2013. All admissions to the medical wards from the emergency department and medical out-patient department clinics during the study period were included.ResultsA total of 339 patients were studied and stroke was the commonest type of cardiovascular disease (CVD) admitted (187; 55.2%). Hypertension was the commonest cause of heart failure (70; 48.6%). Presentation to hospital during after-hours and length of stay of more than 14 days were significant predictors of death (OR: 3.37; 0.22).ConclusionAn increase in CVD mortality rates occurred during after-hours, most likely a consequence of uneven staffing patterns and poor access to equipment. Healthcare providers in Nigeria need to consider remedies to this with a view to reducing excess mortality rates.

Cardiovascular Disease Healthcare Utilization in Sub-Saharan Africa: A Scoping Review

“…Reviewed studies examined CVD utilization in eight SSA countries: Nigeria (5), Ghana (3), Tanzania (2), South Africa (4), Ethiopia (1), Mozambique (1), Zimbabwe (1), and Rwanda (1). The majority (16) of studies followed quantitative methodology [23,24,25,26,27,28,30,31,33,34,35,36,37,38,39,40], while 2 studies employed qualitative [32] and mixed methods [29].…”

Data on the epidemiology of heart failure in Sub-Saharan Africa

“…All discrepancies the selection of studies were resolved through discussion or with the arbitrage of a third investigator. A total of 35 studies were included in this review [1] , [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] . A summary of the selection process is presented in the Fig.…”

“… ECG; Cardiac enzymes; Echocardiography High Pio, 2014 [19] Togo Western Urban Cross-sectional Hospital-based Retrospective Files of patients hospitalized with heart failure No NR 36.5 18–45 376 NR Hypertensive heart disease (42.8%); Valvulopathies (18.1%); Peripartum cardiomyopathy (15.4%); Idiopathic dilated cardiomyopathy (5.8%); Alcoholic cardiomyopathy (3.2%); IHD (2.7%); Congenital cardiopathy (2.7%); Cor pulmonale (2.1%); thyrotoxic heart failure (1.8%); Pericardial tamponade (1.1%) and HIV-associated myocarditis (1.1%) ECG; Cardiac enzymes; Echocardiography Low Dokainish, 2015 [22] The INTER-CHF registry SSA – Cohort Hospital-based Prospective, international, multicenter Ambulatory and hospitalized adult patients with heart failure Yes 51.8 53.4 ≥18 1294 Boston criteria of HF Hypertensive heart disease (35%); Ischaemic cardiomyopathy (20%); Idiopathic dilated cardiomyopathy (14.5%); Valvular rheumatic heart disease (7.2%); Endocrine/metabolic heart disease (5.3%); Vavlular non-rheumatic heart disease (2.3%); Alcohol/drug induced cardiopathy (0.7%); HIV cardiomyopathy (0.7%). 12-lead ECG; echocardiography Moderate Ansa, 2016 [24] Nigeria Western NR Cross-sectional Hospital-based Retrospective medical record review All cardiovascular admissions to the medical wards No NR NR ≥18 144 NR Hypertensive heart disease (48.6%); dilated cardiomyopathy (35.4%); Anaemia (14.6%) and Rheumatic heart disease (1.4%) NR Low Abebe 2016 [25] Ethiopia Eastern Urban Chart review Hospital-based Retrospective Medical records of patients admitted for heart failure NR 30.2 53.6 NR 311 ...…”

Cardiac ultrasound in resource-limited settings (CURLS): towards a wider use of basic echo applications in Africa

“…878 titles and abstracts were screened; nine papers provided relevant information on etiologies of cardiac failure in SSA [20][21][22][23][24][25][26][27][28], nine additional papers were identified by reviewing references [18,[29][30][31][32][33][34][35][36].…”