埃塞俄比亚北部阿伊德综合专科医院的医疗入院模式及死亡率预测因素：一项前瞻性观察研究
Patterns of Medical Admissions and Predictors of Mortality in Ayder Comprehensive Specialized Hospital, Northern Ethiopia: A Prospective Observational Study.
作者信息
Hailu Abraha, Gidey Kibreab, Ebrahim Mohamedawel Mohamedniguss, Berhane Yonas, Gebrehawaria Teklay, Hailemariam Tesfay, Negash Atakelti, Mesele Habtamu, Desta Tekleab, Tsegay Haylsh, Alemayohu Mulubirhan Assefa, Bayray Alemayehu
机构信息
Department of Internal Medicine, School of Medicine, Mekelle University - College of Health Sciences, Mekelle, Tigray, Ethiopia.
Department of Biostatistics, School of Public Health, Mekelle University - College of Health Sciences, Mekelle, Tigray, Ethiopia.
出版信息
Int J Gen Med. 2023 Jan 21;16:243-257. doi: 10.2147/IJGM.S385578. eCollection 2023.
BACKGROUND
Previous works show that noncommunicable diseases (NCDs) are on the rise in developing nations, including Ethiopia, in the background of preexisting communicable diseases (CDs). Data on hospital admission in sub-Saharan Africa are scarce, particularly prospectively collected, and hence this study was done to close the gap in acquiring accurate diagnosis usually faced with retrospective data. We aimed to describe medical admission patterns, their outcomes and determinants at Ayder Comprehensive Specialized Hospital (ACSH) in Tigray, Ethiopia.
METHODS
Data were collected prospectively from November 1, 2017 to October 31, 2018 for all medical admissions. Sociodemographic profiles, final diagnosis, outcome of hospitalization, and complications were recorded using a data-abstraction checklist. Data were analyzed using SPSS 26.
RESULTS
There were 2084 medical admissions over 1 year. Median age was 45 years (IQR 31). A majority (1107, 53.1%) were male. The age-group 25-34 years had the most admissions (19.0%). NCDs constituted 68.2% of admissions. According to the , patients were admitted most frequently due to disease of the circulatory system (36.7%) followed by infectious or parasitic diseases (24.1%). Of NCDs, cardiovascular diseases contributed to 53.9%, followed by cancers (8.6%). Of CDs, HIV/AIDS contributed to 31.3%, followed by tuberculosis (22.8%). A total of 1375 (66%) were discharged improved, while 311 (14.9%) died. On multivariate analysis, the in-hospital mortality was significantly higher (18.7%) for CDs than NCDs (13.2%, AOR 1.8, 95% CI 1.4-2.3; <0.001). Bed occupancy of ACSH medical wards and ICU was 54%.
CONCLUSION
NCDs were leading causes of medical admissions in ACSH. The presence of CDs and the development of complications were associated with higher risk of death. Attention should be given by policy-makers to curb the higher morbidity from NCDs and mortality from CDs.
背景
先前的研究表明，在包括埃塞俄比亚在内的发展中国家，在既有传染病（CD）的背景下，非传染性疾病（NCD）正在增加。撒哈拉以南非洲地区关于医院入院情况的数据稀缺，尤其是前瞻性收集的数据，因此开展本研究以弥补通常在回顾性数据中难以获得准确诊断的差距。我们旨在描述埃塞俄比亚提格雷州阿伊德综合专科医院（ACSH）的医疗入院模式、其结局及决定因素。
方法
前瞻性收集2017年11月1日至2018年10月31日期间所有医疗入院患者的数据。使用数据提取清单记录社会人口统计学资料、最终诊断、住院结局及并发症情况。数据采用SPSS 26进行分析。
结果
1年期间共有2084例医疗入院患者。中位年龄为45岁（四分位间距31）。大多数患者（1107例，53.1%）为男性。25 - 34岁年龄组的入院人数最多（19.0%）。非传染性疾病占入院人数的68.2%。根据……，患者因循环系统疾病入院最为频繁（36.7%），其次是感染性或寄生虫病（24.1%）。在非传染性疾病中，心血管疾病占53.9%，其次是癌症（8.6%）。在传染性疾病中，艾滋病毒/艾滋病占31.3%，其次是结核病（22.8%）。共有1375例（66%）患者好转出院，311例（14.9%）死亡。多因素分析显示，传染性疾病的院内死亡率（18.7%）显著高于非传染性疾病（13.2%）（调整后比值比1.8，95%置信区间1.4 - 2.3；P<0.001）。ACSH内科病房和重症监护病房的床位占用率为54%。
结论
非传染性疾病是ACSH医疗入院的主要原因。传染性疾病的存在及并发症的发生与较高的死亡风险相关。政策制定者应关注控制非传染性疾病的较高发病率和传染性疾病的死亡率。
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