Disease patterns and clinical outcomes of medical admissions at a tertiary hospital in Northern Tanzania: A retrospective observational study.

Abstract

The burden of noncommunicable diseases is increasing in developing countries and in settings with an existing communicable burden. The study aim was to identify the disease pattern, length of stay, and clinical outcome of medical admissions. A retrospective observational study of patients admitted to medical wards between 1st July 2019 and 30th June 2020, excluding those admitted for chemotherapy. The outcome measures were the pattern of disease, length of stay, and clinical outcome. A total of 3930 patients were analyzed. A total of 53.5% were males, and 42.9% were aged 51-75 years, with a median age of 57 years (IQR 41-71). A total of 41.3% had health insurance, 21.7% died, and the median length of stay was 6 days (IQR 4-9). Cardiovascular diseases were the most common diagnosis (26.8%) on admission and cause of death (27.9%). The common causes of death were stroke (15.1%), chronic kidney disease (11.1%), and heart failure (9.0%). Noninsured patients had a high mortality risk (odds ratios [OR] 1.67, 95% confidence interval [CI] 1.42-1.96), which was also seen among patients aged more than 75 years (OR 1.3, 95% CI 1.08-1.57), patients with communicable diseases (OR 1.44, 95% CI 1.23-1.68), and weekend admissions (OR 1.29, 95% CI 1.08-1.55). The 72-h admission window is critical due to a very high mortality risk (OR 3.03, 95% CI 2.58-3.56). Cardiovascular diseases are the leading cause of hospital admissions and deaths in a tertiary hospital in Northern Tanzania. Lifestyle modification, health education, and community resources are needed to combat the growing burden of cardiovascular and renal disease.