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

Abstract

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.

Keywords: Admissions, diabetes, endocrine‑related diseases, hyperglycaemia, hypoglycaemia emergency, mortality

Nigerian Medical Journal | Vol. 54 | Issue 4 | July-August | 2013