Investigation of non-communicable diseases prevalence, patterns, and patient outcomes in hospitalized populations: a prospective observational study in three tertiary hospitals

Abstract

Background: Non-communicable diseases (NCDs) pose a significant global health challenge, constituting over 80% of mortality and morbidity. This burden is particularly pronounced in low- and middle-income countries (LMICs), including Ethiopia. Despite this, there's limited research on this issue in Africa. This study aims to investigate the prevalence, patterns, and outcomes of NCDs in hospitalized populations across three tertiary hospitals in Ethiopia.

Methods: A hospital-based cohort study (August 2022 - January 2023) included patients aged 14 and older diagnosed with cardiovascular diseases (CVDs), diabetes mellitus (DM), chronic obstructive pulmonary disease (COPD), asthma, or cancer at three Ethiopian hospitals. Data on demographics, socio-economic factors, clinical characteristics, and outcomes were collected through medical records and interviews. Logistic regression identified factors independently associated with in-hospital mortality, with p ≤ 0.05 considered statistically significant.

Results: In the study across three tertiary hospitals involving 2,237 patients, we uncovered the impact of NCDs. About 23.4% of patients struggled with NCDs, with cardiovascular diseases (53.3%), cancer (29.6%), diabetes (6.1%), and respiratory diseases (6.5%) being the most prevalent. Notably, among those affected, women comprised a slight majority (55.1%), with the average patient age being 47.2 years. Unfortunately, 15.3% of patients with NCDs faced in-hospital mortality. Our analysis revealed predictors of mortality, including cancer diagnosis (adjusted odds ratio [AOR]:1.6, 95% CI: 1.2-1.8, p = 0.01), medication adherence ( AOR: 0.36, 95% CI: 0.21-0.64, p < 0.001), concurrent infections (AOR: 0.36, 95% CI: 0.16-0.86, p < 0.001), chronic kidney diseases (CKD) (AOR: 0.35, 95% CI: 0.14-0.85, p = 0.02), and complications during hospitalization (AOR: 6.36, 95% CI: 3.45-11.71, p < 0.001).

Conclusion: Our study reveals a substantial prevalence of NCDs among hospitalized patients, affecting approximately one in four individuals, primarily with CVDs and cancer. Alarmingly, a significant proportion of these patients did not survive their hospitalization, emphasizing the urgent need for targeted interventions to enhance outcomes in this population.

Keywords: Clinical outcomes; Hospital admissions; Non-communicable diseases; Socio-economic disparities.

Fig. 1

Patterns of NCD in hospitalized patients by demographic and socioeconomic characteristics. NCD: Non-Communicable Disease, CVD: Cardiovascular Disease, DM: Diabetes Mellitus, RD: Respiratory Disease. *Included patients with no reported income [7], those who were uncertain (59), and those who refused to disclose their income [34]

Fig. 2

Pattern of NCDs by age category. DM: diabetes mellitus, RD: respiratory disease, CVD: cardiovascular disease, NCDs: non-communicable diseases

Fig. 3

Frequency of CVDs among hospitalized patients. *Heart failure + atrial fibrillation [5], Heart failure + coronary heart diseases [6], Atrial fibrillation [2], Atrial fibrillation + rheumatic heart disease [6], Hypertension + stroke [9], Rheumatic heart disease [7], Heart failure + venous thromboembolism [6], Heart failure + asthma [1], Coronary heart diseases + peripheral artery disease [2], Heart failure + atrial fibrillation + rheumatic heart disease [3], Heart failure + hypertension [8], Peripheral artery disease [1], Dyslipidemia [1]

Fig. 4

Frequency of cancer types among hospitalized patients

Fig. 5

Number of patients received discharge medications. CVDs: cardiovascular diseases, DM: diabetes mellitus, ACE inhibitors: Angiotensin converting enzyme inhibitors, ARBs: Angiotensin receptor blockers

Fig. 6

Relationship between NCD and mortality among hospitalized patients

Fig. 7

Patterns of in hospital-mortality among hospitalized patients with NCDs