Trends of admissions and case fatality rates among medical in-patients at a tertiary hospital in Uganda; A four-year retrospective study

• Published in: PloS one 2019-05, Vol.14 (5), p.e0216060-e0216060
• Main Authors: Kalyesubula, Robert, Mutyaba, Innocent, Rabin, Tracy, Andia-Biraro, Irene, Alupo, Patricia, Kimuli, Ivan, Nabirye, Stella, Kagimu, Magid, Mayanja-Kizza, Harriet, Rastegar, Asghar, Kamya, Moses R
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Adenomatous polyposis coli; Adolescent; Adult; Adults; Aged; Aged, 80 and over; AIDS; Biology and Life Sciences; Cancer; Care and treatment; Cause of Death - trends; Chronic diseases; Chronic kidney failure; Communicable diseases; Comorbidity; Death; Diabetes; Fatalities; Female; Females; Forecasts and trends; Health care; Health care reform; Health sciences; Health services; Heart; Heart diseases; Heart failure; HIV; Hospital Mortality - trends; Hospital patients; Hospitalization; Hospitalization - trends; Hospitals; Human immunodeficiency virus; Humans; Hypertension; Infectious diseases; Kidney diseases; Malaria; Male; Medical diagnosis; Medical examination; Medical records; Medical referrals; Medical tests; Medicine; Medicine and Health Sciences; Middle Aged; Morbidity; Mortality; Motor vehicle drivers; Nephrology; Patient Admission - trends; Patient outcomes; Patients; Pneumonia; Poisson density functions; Regression analysis; Retrospective Studies; Risk factors; Statistical analysis; Stroke; Studies; Survival; Systematic review; Tertiary Care Centers - trends; Trends; Tuberculosis; Uganda; Vector-borne diseases; Young Adult
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0216060

Sub-Saharan Africa suffers from a dual burden of infectious and non-communicable diseases. There is limited data on causes and trends of admission and death among patients on the medical wards. Understanding the major drivers of morbidity and mortality would help inform health systems improvements. We determined the causes and trends of admission and mortality among patients admitted to Mulago Hospital, Kampala, Uganda. The medical record data base of patients admitted to Mulago Hospital adult medical wards from January 2011 to December 2014 were queried. A detailed history, physical examination and investigations were completed to confirm the diagnosis and identify comorbidities. Any histopathologic diagnoses were made by hematoxylin and eosin tissue staining. We identified the 10 commonest causes of hospitalization, and used Poisson regression to generate annual percentage change to describe the trends in causes of hospitalization. Survival was calculated from the date of admission to the date of death or date of discharge. Cox survival analysis was used to identify factors associate with in-hospital mortality. We used a statistical significance level of p