Pediatr Emerg Med J.  2023 Jan;10(1):3-10. 10.22470/pemj.2022.00598.

The pattern of mortality among children hospitalized in the children emergency ward of a single tertiary hospital in Nigeria

• Onubogu UC
• West BA
• Azubogu US

• KMID: 2538076
• DOI: http://doi.org/10.22470/pemj.2022.00598

Abstract

Purpose
This study was performed to review the mortality pattern at the emergency ward (EW) of the Rivers State University Teaching Hospital, Port Harcourt, Nigeria.
Methods
A retrospective review of mortality among children hospitalized in the EW was conducted from January 2015 through May 2017. Information on their age, sex, weight, diagnosis, and mortality was recorded. The data were expressed in frequencies, and logistic regressions were performed with mortality as the dependent variable.
Results
The median age of the 1,020 children hospitalized in the EW was 1.0 year (interquartile range, 0.6-4.0) with death recorded in 60 children, a 5.9% mortality rate. Mortality was higher in the children younger than 2 years, boys, and those with infectious diseases. Of the 60 dead children, infectious diseases were the leading cause of mortality (53 [88.3%]) with sepsis (22 [36.7%]), gastroenteritis (10 [16.7%]), and meningitis (6 [10.0%]), accounting for the highest contributors to mortality. The highest case fatality rates were noted in tetanus (1/1 [100%]), human immunodeficiency virus (5/14 [35.7%]), and tuberculosis (2/7 [28.6%]). The logistic regression showed that age of 13-16 years (adjusted odds ratio, 4.59; 95% confidence interval, 1.80-11.20; compared with age < 2 years) and presence of infectious diseases (4.65; 1.80-12.10) significantly increased the risk of mortality.
Conclusion
The mortality rate in our EW during the study period was 5.9%. Infectious diseases remained significant contributors to mortality in our practice. Greater efforts at prevention and control of the diseases are required to correct this negative trend.

Keyword

Child; Communicable Diseases; Emergencies; Gastroenteritis; Meningitis; Mortality; Sepsis

Figure

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  Fig. 1. Diseases that contributed to mortality in the emergency ward (n = 60). The numerical data were as follows: sepsis, 22 (36.7%); gastroenteritis, 10 (16.7%); meningitis, 6 (10.0%); human immunodeficiency virus, 5 (8.3%); malaria, 5 (8.3%); acute respiratory infection, 2 (3.3%); acute renal failure or glomerulonephritis, 2 (3.3%); tuberculosis, 2 (3.3%); undocumented, 2 (3.3%); acute abdomen, 1 (1.7%); poisoning or foreign body, 1 (1.7%); sickle cell disease, 1 (1.7%); and tetanus, 1 (1.7%).

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  Fig. 2. Case fatality rate of diseases in the emergency ward. The numerical data were as follows: tetanus, 1/1 (100%); human immunodeficiency virus, 5/14 (35.7%); tuberculosis, 2/7 (28.6%); acute renal failure or glomerulonephritis, 2/8 (25.0%); sepsis, 22/111 (19.8%); meningitis, 6/61 (9.8%); undocumented, 2/22 (9.1%); gastroenteritis, 10/115 (8.7%); poisoning or foreign body, 1/12 (8.3%); acute abdomen, 1/18 (5.6%); sickle cell disease, 1/29 (3.4%); malaria, 5/203 (2.5%); and acute respiratory infection, 2/180 (1.1%).

Reference

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