Patterns of Medical Admissions and Predictors of Mortality in Ayder Comprehensive Specialized Hospital, Northern Ethiopia: A Prospective Observational Study

Figures & data

Table 1 Sociodemographic characteristics of patients (n=2084)

	n (%)
Age (years), median 45 (IQR 31)
<25	259 (12.4)
25–34	396 (19.0)
35–44	365 (17.5)
45–54	332 (15.9)
55–64	256 (12.3)
65–74	285 (13.7)
75+	191 (9.2)
Sex
Male	1107 (53.1)
Female	977 (46.9)
Region
Tigray	1945 (93.3)
Afar	74 (3.6)
Amhara	58 (2.8)
Addis Ababa	4 (0.2)
Eritrea	2 (0.1)
Oromia	1
Residence
Urban	1109 (53.2)
Rural	975 (46.8)

Table 2 International Classification of Diseases 10 category of medical admissions (n=2084)

	Reason for Admission	Sex, n (%)		n (%)
		Male	Female
A or B	Infectious or parasitic diseases	308 (61.4)	194 (38.6)	502 (24.1)
C	Cancers	74 (60.2)	49 (39.8)	123 (5.9)
D	Disease of the blood	57 (49.1)	59 (50.9)	116 (5.6)
E	Endocrine, nutrition, and metabolic diseases	39 (48.8)	41 (51.3)	80 (3.8)
G	Disease of the nervous system	73 (64.0)	41 (36.0)	114 (5.5)
I	Disease of the circulatory system	345 (45.0)	422 (55.0)	767 (36.8)
J	Disease of the respiratory system	55 (44.0)	70 (56.0)	125 (6.0)
K	Disease of the digestive system	62 (68.1)	29 (31.9)	91 (4.4)
M	Spondylopathies and musculoskeletal disorders	3 (27.3)	8 (72.7)	11 (0.5)
N	Disease of the genitourinary system	64 (64.0)	36 (36.0)	100 (4.8)
O	Miscellaneous conditions	27 (49.1)	28 (50.9)	55 (2.6)

Note: ²₁₀=64.5, P<0.001.

Figure 1 Distribution of CDs vs NCDs by age-group (n=2084).

Figure 2 Types of CDs causing admissions (n=2084).

Figure 3 Types of NCDs causing admissions (n=2084).

Table 3 Length of hospital stay and outcomes (n=2084)

	n (%)
Outcomes
Death	311 (14.9)
Discharge	1706 (81.9)
Referral to better setup	42 (2.0)
Transfer to continue same treatment	25 (1.2)
Condition at discharge (n=1706)
Improved	1375 (80.6)
Same condition	74 (4.3)
Left against medical advice	257 (15.1)
Length of hospital stay (days), median 9 (IQR 9)
≤5 days	610 (29.3)
6–10 days	668 (32.1)
11–15 days	370 (17.8)
>15 days	436 (20.9)

Table 4 Complications (n=2084)

	n (%)
None	1739 (83.5)
Hospitalization	157 (7.5)
Disease progression	150 (7.2)
Both hospitalization and disease progression	38 (1.8)
Complications of hospitalization (n=157)
Aspiration pneumonia	63 (40.1)
Hospital-acquired pneumonia	47 (29.9)
Acute kidney injury	24 (15.3)
Other	23 (14.7)
Disease progression (n=150)
Septic shock	17 (11.3)
Cardiogenic shock	18 (12.0)
Electrolyte abnormalities	23 (15.3)
Other	92 (61.4)

Figure 4 Factors associated with aspiration pneumonia (n=63).

Notes: *Parkinson’s Disease, Tuberculoma, Chronic Kidney disease, upper gastrointestinal bleeding, chronic liver disease, Guillain Bare Syndrome, Heart failure, Severe Diabetic Ketoacidosis

Table 5 Factors associated with development of acute kidney injury and outcomes (n=24)

	n (%)
Sepsis	5 (20.8)
Heart failure	4 (16.7%)
Acute coronary syndrome	2 (8.3%)
Chronic liver disease	2 (8.3%)
HIV/AIDS	2 (8.3%)
Severe and complicated malaria	2 (8.3%)
Stroke	2 (8.3%)
Other^#	5 (20.8)

Note: ^#Pulmonary embolism, tetanus, meningitis, multiple myeloma, and diabetes.

Figure 5 Comorbidities (n=2084).

Notes: *Hypertensive heart disease, **Community acquired pneumonia, +Degenerative valvular heart disease.

Figure 6 Top ten causes of death (n=311).

Notes: *Acute and chronic decompensated heart failures, acute coronary syndromes. **Chronic kidney disease and acute kidney injury.

Table 6 Predictors of death (n=2084)

	Deaths, n (%)		COR (95% CI)	P	AOR (95% CI)	P
	No	Yes
Age-group (years)
≤40	810 (86.4)	128 (13.6)	1		1
>40	963 (84.0)	183 (16.0)	1.2 (0.9–1.5)	0.139	1.2 (0.9–1.6)	0.130
Disease category
Noncommunicable	1231 (86.6)	191 (13.4)	1		1
Communicable	542 (81.9)	120 (18.1)	1.4 (1.1–1.8)	0.005	1.6 (1.2–2.1)	<0.001
Complication
Yes	220 (63.8)	125 (36.2)	4.7 (3.6–6.2)	<0.001	4.9 (3.7–6.4)	<0.001
No	1553 (89.3)	186 (10.7)	1		1
Comorbidity
Yes	463 (84.6)	84 (15.4)	1.0 (0.8–1.4)	0.741	1.0 (0.8–1.4)	0.786
No	1310 (85.2)	227 (14.8)	1		1

Table 7 Length of hospital stay vs outcome of hospitalization (n=2084)

Outcome	Length of hospital stay (days), n (%)				Total
	0–5	6–10	11–15	>15
Death	181 (58.2)	55 (17.7)	32 (10.3)	43 (13.8)	311
Discharged	400 (23.5)	599 (35.1)	329 (19.3)	378 (22.2)	1706
Referral to better setup	19 (45.2)	10 (23.8)	7 (16.7)	6 (14.3)	42
Transfer to continue same treatment	10 (40.0)	4 (16.0)	2 (8.0)	9 (36.0)	25
Total	610 (29.3)	668 (32.1)	370 (17.8)	436 (20.9)	2084

Note: Pearson ²₉=166.946, P<0.001.