Endocrine-related diseases in the emergency unit of a Tertiary Health Care Center in Lagos: A study of the admission and mortality patterns.

Anyanwu, A.C ; Odeniyi, I.A ; Fasanmade, O.A ; Adewunmi, A.J ; Adegoke, O.A ; Mojeed, A ; Olofin, K ; Ohwovoriole, A.E (2013)

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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.