In-patient morbidity and mortality patterns among patients with diabetes in Southwest Nigeria: A multicenter prospective study

Abstract

Background: Diabetes is a disease of public concern with increasing hospital admissions and mortality in developing countries. Hence, we aimed to determine the patterns of in-hospital morbidity and mortality in patients admitted for diabetes. Methods: A prospective multicenter analysis of the causes of hospital admission and death among patients with type 2 diabetes who were admitted from diabetic clinic and emergency units over a 3-month period in selected tertiary hospitals in southwest, Nigeria was conducted. Data analysis was performed using the SPSS version 21.0. Results: A total of 341 patients with diabetes were admitted with a mean age of 59.6 ± 15.6 years and overall mortality of 14 deaths (4.4%). Almost three-fifths (59.5%) were previously known patients with diabetes with a mean duration of 52.44 ± 30.02 months. Two hundred and thirty-one (70.9%) patients were admitted through the emergency units and others through outpatient clinics. The duration of hospital stay ranged from 1 to 135 days, with a mean duration of 24.5 ± 14.7 days. The diabetes-related indications for admission were hyperglycemic crisis (diabetes ketoacidosis [DKA] and hyperglycemic hyperosmolar state [HHS]) (59.8%), diabetic foot ulcer [DFU], (11.7%), hypoglycemia (7.6%), and infections (7.3%). Among the diabetes-related diagnoses, 100%, 77.8%, 50.0%, 41.7%, and 28.3% of patients with chronic kidney disease, stroke, DFU, DKA, and HHS respectively stayed longer than 10 days on admission. Conclusion: Diabetes still contributes high cause of morbidity in our hospitals but with a reduced mortality compared to previously reported figure. Hence, continued emphasis on early diagnosis with improvements in diabetes care will help to improve diabetes outcomes.