Ckd commonest cause of death

ARODIWE EB, IKEH SO, NWOKEDIUKO SN, IJOMA CK,

ULASI II, ONODUGO OO, AFOLABI OF.

DEPARTMENT OF MEDICINE

UNIVERSITY OF NIGERIA TEACHING HOSPITAL

ITUKU-OZALLA, ENUGU, SOUTH- EAST NIGERIA

CHRONIC KIDNEY DISEASE IS THE COMMONEST CAUSE OF DEATH IN THE

ADULT MEDICAL WARD OF UNTH, ENUGU.

INTRODUCTION.

NANCONF, ENUGU 2012

2

Recent population studies have shown that most

developing regions of the world are undergoing gradual

epidemiological transition resulting in high burden of

both communicable and non-communicable diseases[1].

Periodic reviews of morbidity and mortality could show

new trends and may provide information for the

planning and evaluation of health care delivery services

of a country.

INTRODUCTION….

NANCONF, ENUGU, 2012

3

National register of deaths should provide this data but

such are not readily available in many developing

countries and in- hospital review of deaths is then a

viable option.

OBJECTIVES


4

To determine the causes of death at the Adult Medical wards of the University of Nigeria Teaching Hospital, Enugu between January 1995 to January 2005.

METHOD


5

Medical records of in-patients admitted into the

medical wards from January 1995 to January 2005

were reviewed.

Data were obtained from hospital death registers

and case records of all patients who died during the

period under review.

Other sources of data- ward admissions/death

register & death certificates.

METHOD…..


6

Age, sex, & causes of death were extracted from the

above records and analyzed using SPSS version 15.0.


7

RESULTS /

DISCUSSIONS

Table 1. Age and Sex Distribution.


8

16,368

MR-

28.3%

Age Group Males Females All

Number % Number % Number %

10 - 19 115 2.5 86 1.9 201 4.3

20 - 29 416 9.0 273 5.9 689 14.9

30 - 39 535 11.5 327 7.1 862 18.6

40 - 49 566 12.2 242 5.2 808 17.4

50 - 59 481 10.4 256 5.5 737 15.9

60 - 69 419 9.0 273 5.9 692 14.9

≥70 421 9.1 227 4.9 648 14.0

Total 2953 63.7 1684 36.3 4637 100

Table 1 Contd……


9

Mean Age ± SD (All) = 47.4±17.7

Mean Age ± SD (Males) = 47.8±17.5

Mean Age ± SD (Females) = 46.6 ±18.1

Table II. Systemic Distribution of Causes of Death


10

System Frequency Percentage (%)

Infections 896 19.3

Renal 799 17.2

Cardiovascular 704 15.2

Neuro-muscular 695 15.0

Gastrointestinal/hepatic 608 13.1

Respiratory 380 8.2

Haematological/Immunological

274 5.9

Endocrine/Metabolic 239 5.2

Miscellaneous 42 0.9

TOTAL 4637 100.0

Table III. Causes of Death from Infectious Diseases.


11

Causes Frequency % of all Deaths

HIV/AIDS 352 7.59

Septicaemia 284 6.13

Meningitis 120 2.59

Tuberculosis(TB) 87 1.88

Tetanus 19 0.41

TB/HIV 12 0.26

Malaria 11 0.24

Typhoid 7 0.15

Others 4 0.08

Total(% of all deaths) 896 19.33

Table IV. Causes of Death from Renal Diseases.


12

Causes Frequency % 0f all deaths

Chronic kidney disease 646 13.93 *

Acute kidney injury 112 2.42

Nephrotic syndrome 14 0.30

Electrolyte abnormalities 11 0.24

Prostate cancer 10 0.22

Acute Pyelonephritis 2 0.04

Renal cell carcinoma 2 0.04

Others 2 0.04

Total 799 17.23

Table V. Causes of Death from Cardiovascular Diseases


13

Cause Frequency % of all deaths

Heart failure 432 9.32 ***

Cardiac arrhythmias 112 2.42

Hypertensive encephalopathy

86 1.85

Acute pulmonary oedema 65 1.40

Infective endocarditis 6 0.13

Cor-Pulmonale 2 0.04

Myocardial infarction 1 0.02

Total 704 15.18

Table VI. Causes of Death from Neurological Diseases


14

Cause Frequency % of all deaths

Cerebrovascular accident 479 10.33 **

Organic brain syndrome 73 1.57

Space occupying lesion 63 1.36

Encephalitis 35 0.75

Spinal cord disease 14 0.30

Seizure 11 0.24

Dementia 8 0.17

Parkinson's disease 4 0.09

Miscellaneous 7 0.15

Total 694 14.96

Table VII. Causes of death from Gastrointestinal and Hepatic system


15

Causes Frequency % of all deaths

Chronic liver disease 299 6.45

Hepatoma 133 2.87

Acute viral hepatitis 49 1.06

Intra-abdominal malignancy

33 0.71

Gastrointestinal bleeding 26 0.56

Amoebic liver disease 13 0.28

Peptic ulcer disease 12 0.26

Abdominal tuberculosis 8 0.18

Obstructive jaundice 4 0.09

Others 10 0.22

Total 608 13.12

Table VIII. Causes of death from chest diseases.

WACP, BANJUL 6-11 NOV. 2011

16


Respiratory failure 203 4.37

Pulmonary embolism 48 1.04

Bronchopneumonia 30 0.65

Aspiration pneumonitis 27 0.58

Lobar pneumonia 19 0.41

COPD 15 0.32

Bronchogenic carcinoma 13 0.28

Bronchial asthma 8 0.17

ARDS 7 0.15

Pleural effusion 6 0.13

Lung abscess 2 0.04

Empyema thoracis 2 0.04

Total 380 8.19

Table IX. Causes of death from Haematological / Immunological diseases.


17


Leukaemias 79 1.73

Anaemias 69 1.49

Lymphomas 57 1.23

Sickle cell anaemia 18 0.39

Multiple myeloma 13 0.28

Connective tissue diseases 11 0.24

Autoimmune diseases 7 0.15

Disseminated intravascular coagulation 4 0.09

Tropical splenomegally syndrome 3 0.06

Others 13 0.28

Total 274 5.91

Table X. Causes of death from Endocrine and metabolic diseases.


18

Causes Frequency % of all death

Diabetes mellitus 149 3.21

Diabetic coma 61 1.32

Hypoglycaemic coma 13 0.28

Thyroid diseases 6 0.13

Diabetic foot ulcer 5 0.11

Addison’s disease 1 0.02

Phaeochromocytoma 1 0.02

Others 3 0.06

Total 239 5.15

COMMONEST CAUSES OF DEATH IN THE SYSTEMS


19

Systems Causes Percentage (%)

Renal CKD 13.93 *

Infections HIV/AIDS 7.59 ****

CVS Heart failure 9.32 ***

Neurological CVA 10.33 **

GI/Hepatic CLD 6.45

Chest Respiratory failure 4.37

Heamatological/Immunological

Leukaemia 1.73

Endocrinology/Metabolic DM 3.21

DISCUSSION.


20

The mortality rate was 28.3% and is comparable with findings in most West African countries -23.9%(Ilorin, Nigeria)², 25.3%(Kano, Nigeria)³, 23.3%(Liberia)⁴.

Majority(66.8%) of the victims were in their 3rd and 5th decade of life(20-59) years – the most productive age group, comparable to findings in most subsahara African countries but much lower than in North America and Europe2,3

DISCUSSION…..


21

Infections (19.3%) were the commonest cause of death. This has consistently been the case in most Sub-Saharan African countries unlike in western countries where coronary artery diseases has always been responsible for most medical deaths2,3,5,6

HIV/AIDS alone or in combination with TB was the commonest infectious disease causing death. This agrees with most findings in our environment.²,3,7

DISCUSSION….


22

CKD was the single commonest disease entity causing death(13.9% of all deaths). This is quite different from most of the findings in Sub-Saharan Africa2,3,4 .

CGN, HTN & DM have been implicated in most cases of ESRD in Nigeria.8,9

The incidence of hypertension and diabetes mellitus are increasing rapidly with largely underdeveloped facilities on ground in most Sub-Saharan African countries to manage their complications.

DISCUSSION…


23

Three noncommunicable diseases (CKD, CVA, HF) were responsible for a 3rd of the deaths(33.6%).

It is important to note that diseases like IHD, Tetanus, Malaria, and Typhoid were uncommon causes of death. Many studies in our environment have also reported similar findings2,3,4,5

CONCLUSION


24

Efforts should be intensified at population screening for early detection and prevention of common risk factors for most non-communicable diseases such as hypertension and diabetes.

Also interventions targeted at interrupting transmission of infections like HIV/AIDS and TB should also be intensified.


25

THANK

YOU.

REFERRENCES


26

1. Omran AR. The Epidemiological Transition Theory: A preliminary update. J of Trop

Paed 1983; 29: 6305-6316.

2. Chijioke A, Kolo PM. Mortality pattern at the adult medical wards of a teaching

hospital in Sub-Saharan Africa. International journal of tropical medicine 2009 ;

4(1): 27-31.

3. Sanni MU, Mohammed AZ, Bappa A, Borodo MM. A three- year review of mortality

patterns in the medical wards of Aminu Kano teaching hospital, Kano, Nigeria. The

Nigerian postgraduate medical journal; 2007 14(4):347-51.

4. Huerga H, Vasset B, Prados E. Adult and Paediatric mortality patterns in a referral

hospital in Liberia one year after the end of the war. Transactions of the Royal

society of Tropical medicine and Hygiene 2009.103: 476-484.

5. Gwarkin DR, Guillot M, Heuveline P. The burden of diseases among the global poor.

Lancet 1999. 354: 586-589.

6. Yusuf S, Reddy S, Ounpun S, Anand S. Global burden of cardiovascular diseases:

Part 1: general considerations, the epidemiologic transition, risk factor and impact of

urbanization. Circulation , 2001. 104: 2746-2753.

7. Harries AD, Mvula B. The changing pattern of mortality in an African medical ward.

Trop. Geog. Med. 1995. 47(4): 171-174.

REFERRENCES…


27

8. Ulasi II, Arodiwe EB, Ijoma CK. Left ventricular hypertrophy in African black patients

with chronic renal failure at first evaluation. Etnicity and Dis . 2006; 16:859-864.

9. Alebiosu CO, Ayodele OO, Abbas A, Olutoyin AI. Chronic renal failure at the Olabisi OnabanjoUniversity Teaching hospital, Sagamu. Afr. Health Sci., 2006; 6(3): 132-138.

Date post:	22-Jul-2015
Category:	Documents
Upload:	owen-maduka
View:	67 times
Download:	1 times

Ckd commonest cause of death

Documents