Pattern and outcome of diabetic admissions at a federal medical center: a 5-year review

Abstract

Background: Prevalence of diabetes mellitus (DM) is increasing worldwide, with the major increases expected to occur in developing countries. It has been observed that the pattern of hospital admissions can be used to determine the effectiveness of outpatient care of DM.

Objective: This study was aimed to examine diabetes-related admissions to medical wards of a federal medical center in Ekiti, Nigeria. Such data would be useful to determine the burden on health care system and in the planning of appropriate management strategies.

Methods: A 5-year retrospective analysis of diabetes-related admissions to the medical wards of Federal Medical Centre, Ido Ekiti, Ekiti State, between 2003 and 2007 was carried out using medical records of the patients. SPSS 13 software was used to analyze data.

Results: Of the total 2,696 medical admissions, 118 (4.4%) were diabetes related. The mean age of these patients was 57 +/- 16.2 years. Majority (37.29%) of the patients were admitted for diabetic foot ulcer. Other major reasons for admission were severe hypertension (13.56%), uncontrolled hyperglycemia (13.56%), hyperglycemic emergencies (11.86%) and stroke (10.17%). Duration of hospital stay ranged from 1 to 107 days, with a mean duration of 17.5 +/- 9.2 days. Mean duration of hospital stay was the longest (25.3 +/- 23.9 days) for those admitted for diabetic foot ulcer. Most (74.6%) of the patients were discharged and only 4 (3.4%) died. Majority of those who left against medical advice were admitted for diabetic foot ulcer.

Conclusion: There is a need to emphasize foot care as one of the cardinal features of optimal diabetes care. Establishing clinics specializing in treating diabetes and having facilities for treatment of all aspects of diabetes, including diabetic complications, will help in providing better patient care and in minimizing hospital admissions.