Department of Mathematics and Actuarial Science, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
Ghana Health Service, Accra, Volta Region, Ghana.
BMJ Open. 2023 May 8;13(5):e066457. doi: 10.1136/bmjopen-2022-066457.
Hospitalisation for hypertension continues to rise in Ghana. It has been revealed that in Ghana, patients hospitalised for hypertension spend between 1 and 91 days on admission. This study therefore sought to estimate the hospital length of stay (LoS) of hypertensive patients and individual or health-related factors that may influence the hospitalisation duration in Ghana.
We employed a retrospective study design that used routinely collected health data on hospitalised hypertensive patients in Ghana from the District Health Information Management System database between 2012 and 2017 to model LoS using survival analysis. The cumulative incidence function for discharge stratified by sex was computed. To investigate the factors that influence hospitalisation duration, multivariable Cox regression was used.
Out of a total of 106 372 hypertension admissions, about 72 581 (68.2%) were women. The mean age of the patients was 55.3 (SD=17.5) years. Overall, the median LoS was 3 days with almost 90% of all patients being discharged by the 10th day of admission. Patients admitted in Volta region (HR: 0.89, p<0.001) and Eastern region (HR: 0.96, p=0.002) experienced late discharge as compared with patients admitted in Greater Accra. It was revealed that women (HR: 1.09, p<0.001) were discharged earlier than men. However, having a surgical procedure (HR: 1.07, p<0.001) and having comorbidities such as diabetes (HR: 0.76, p<0.001) and cardiovascular diseases other than hypertension (HR: 0.77, p<0.001) increased the LoS of patients.
This study provides the first comprehensive assessment of factors influencing hospitalisation duration of admissions due to hypertension in Ghana. Female sex, all regions except Volta region and Eastern region, experienced early discharge. However, patients with a surgical intervention and comorbidity experienced late discharge.
高血压在加纳的住院率持续上升。据透露，加纳因高血压住院的患者平均住院时间为 1 至 91 天。因此，本研究旨在评估加纳高血压患者的住院时间，并分析可能影响住院时间的个体或健康相关因素。
本研究采用回顾性研究设计，利用 2012 年至 2017 年期间加纳地区卫生信息管理系统数据库中常规收集的高血压住院患者健康数据，通过生存分析模型来评估住院时间。按性别分层计算出院累积发生率函数。为了研究影响住院时间的因素，我们采用多变量 Cox 回归分析。
在总共 106372 例高血压住院病例中，约 72581 例（68.2%）为女性。患者的平均年龄为 55.3（SD=17.5）岁。总体而言，中位住院时间为 3 天，几乎 90%的患者在入院第 10 天前出院。与在大阿克拉地区入院的患者相比，在沃尔特地区（HR：0.89，p<0.001）和东部地区（HR：0.96，p=0.002）入院的患者出院时间较晚。研究结果显示，女性（HR：1.09，p<0.001）比男性更早出院。然而，手术治疗（HR：1.07，p<0.001）以及合并症如糖尿病（HR：0.76，p<0.001）和除高血压以外的心血管疾病（HR：0.77，p<0.001）会增加患者的住院时间。
本研究首次全面评估了影响加纳高血压住院时间的因素。女性、除沃尔特地区和东部地区以外的所有地区的患者住院时间较短。然而，接受手术治疗和合并症的患者住院时间较长。
