Department of Medicine

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Browsing Department of Medicine by Subject "Admission"

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    Open Access
    Admission blood pressure of stroke patients and its relationship to one-week case fatality-a preliminary study.
    (Lagos University Medical Society (LUMS), 2002-01) Ojini, F.I.; Okubadejo, N.U.; Ogun, S.A.; Akokhia, S.I.; Danesi, M.A.
    Background: High blood pressure is often said to be associated with poor outcome in stroke. However, there remains some uncertainly about the relationship of blood pressure to mortality in stroke. Objective: This study seeks to determine the influence of admission blood pressure on early mortality of stroke patients at the Lagos University Teaching Hospital (LUTH). Methods: Clinical and laboratory data were collected prospectively according to a standardized protocol, from stroke patients admitted to LUTH in 1999 and 2000, and information obtained about the time of onset of stroke, history of hypertension, level of consciousness, admission blood pressure, ECG findings of left ventricular hypertrophy, and one-week outcome. Results: hypertension was present in 87.3% of strokes on presentation. Strokes with mild to moderate hypertension had the lowest case fatality of 5.6%, while those with isolated systolic hypertension had the highest fatality of 40%. There was a u-shaped relationship between admission blood pressure and one-week case fatality, with strokes that had mild to moderate hypertension having a significantly lower one-week case fatality than strokes with normal blood pressure and severe hypertension Conclusion: Most patients with stroke have hypertension on presentation. It appears that mild to moderate hypertension on presentation is associated with a significantly better one-week outcome for stroke patients than other categories of blood pressure.
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    Open Access
    Burden of diabetes mellitus foot ulcer in a Nigerian tertiary hospital
    (Nigerian chapter of American Association of Clinical Endocrinologists, 2017-04) Okunowo, B.O; Odeniyi, I.A; Fasanmade, O.A; Iwuala, S.O; Ohwovoriole, A.E
    Background Foot complications in people living with diabetes mellitus can present in a variety of ways. It is responsible for major economic and financial burdens both to the patient, and the community at large. Objective The objective of this study was to assess the burden and outcomes of diabetic foot ulcerations in Nigerians admitted into a tertiary hospital. Method Two years, 2014 and 2015 inpatient records of diabetes mellitus (DM) patients admitted into the medical wards of the Lagos University Teaching Hospital (LUTH) in south-western Nigeria were reviewed. The following data were obtained from the records - age and sex of patients, indication for admission, duration of stay in the hospital, and outcome of inpatient management. Regarding outcome, 143 (56.7%) of the patients had complete data for analysis and these constituted a group for sub-analysis. Data management and statistical analyses were entered into Microsoft excel and cleaned up. Analyses were carried out using SPSS 22. Descriptive statistics were presented as mean and standard deviation while inferential statistics as student t-test. Results were presented as tables, figures, and tests. Results During the period under review, 2232 patients were admitted into the medical wards of the hospital. Out of these, 252 (11.3%) were diabetic patients of which 108(42.9%) were males and 144(57.1%) were females. Of the 252 patients, 143 had full data and they are further analyzed for the outcome of admission. The average ages of the males and females were similar. Seventy-five (52.4%) patients were admitted on account of diabetic foot ulcers. The mean duration of admission for DMFS was 65days. Diabetes mellitus foot ulceration accounted for the highest case fatality and discharged against medical advice in the two-year period. Conclusion Diabetic foot ulcers are preventable complications of diabetes mellitus, which appear to constitute the main indications for admission of DM patients in LUTH. Case fatality rate associated with diabetic foot ulceration admissions was unacceptably high. There is a need for more advocacy on foot care.
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    Open Access
    Endocrine-related diseases in the emergency unit of a Tertiary Health Care Center in Lagos: A study of the admission and mortality patterns.
    (2013) Anyanwu, A.C; Odeniyi, I.A; Fasanmade, O.A; Adewunmi, A.J; Adegoke, O.A; Mojeed, A; Olofin, K; Ohwovoriole, A.E
    Introduction: Non-communicable diseases are emerging as an important component of the burden of diseases in developing countries. Knowledge on admission and mortality patterns of endocrine-related diseases will give insight into the magnitude of these conditions and provide effective tools for planning, delivery, and evaluation of health-care needs relating to endocrinology. Materials and Methods: We retrieved medical records of patients that visited the emergency unit of the Lagos University Teaching hospital, over a period of 1 year (March 2011 to February 2012) from the hospital admissions and death registers. Information obtained included: Age, gender, diagnosis at admission and death, co-morbidities. Diagnoses were classified as endocrine-related and non-endocrine related diseases. Records with incomplete data were excluded from the study. Results: A total of 1703 adult medical cases were seen; of these, 174 were endocrine-related, accounting for 10.2% of the total emergency room admission in the hospital. The most common cause of endocrine-related admission was hyperglycaemic crises, 75 (43.1%) of cases; followed by diabetes mellitus foot syndrome, 33 (19.0%); hypoglycaemia 23 (13.2%) and diabetes mellitus related co-morbidities 33 (19.0%). There were 39 endocrine-related deaths recorded. The result revealed that 46.1% of the total mortality was related to hyperglycaemic emergencies. Most of the mortalities were sepsis-related (35.8%), with hyperglycaemic crises worst affected (71.42%). However, the case fatalities were highest in subjects with thyrotoxic crisis and hypoglycaemic coma. Conclusion: Diabetic complications were the leading causes of endocrine-related admissions and mortality in this health facility. The co-morbidity of sepsis and hyperglycaemia may worsen mortality in patients who present with hyperglycaemic crises. Hence, evidence of infection should be sought early in such patients and appropriate therapy instituted.