Pattern and Outcome of Cases Seen at the Adult Accident and Emergency Department of the Lagos University Teaching Hospital, Idi-Araba, Lagos

Abstract

Background: The accident and emergency department constitutes one of the vital entry points of patients into the healthcare facility of the hospital the world over. It responds to and manages variety of cases in all the clinical areas and thus provides an insight to the quality of care available in the health institution.
Objective: The aim of this study is to determine the pattern of cases seen as well as the causes of deaths at the adult accident and emergency department of the Lagos University Teaching Hospital, Idi-Araba, Lagos.
Methods: Retrospective review of records of all patients attended to at the adult accident and emergency department of the Lagos University Teaching Hospital in 2009 and 2010 was carried out. Data spread sheet was used to collect data on demographic indices, diagnosis, outcome, date admitted, date discharged and amount paid from casualty attendance register and Nurses' report books. Data was collated and analysed using Epi-Info version 3.4.1 statistical software package.
Results: Out of the 5,427 available patients' records reviewed, 4,761(87.7%) were recorded as “discharged alive”, 546(10.1%) were recorded as “died”, while 120(2.2%) were recorded as “brought in dead”. Of those discharged alive, male attendance was 2,376 (49.10%) while that of the female was 2,385 (50.10%). Majority of these patients were aged 20-39 years and the mean age of the patients was 39.96 ± 18.22 yrs. Majority of cases seen were medical in origin (53.7%) and highest medical case seen was cerebrovascular accident, Commonest cause of death was from medical cases[69.2%] (cerebrovascular accident 22.0%). Male mortality was 55.3% while female mortality was 44.7% , mean age was 46.86 ± 17.61.Most affected age group was 40 – 59 years (35.4%) and highest number of death was seen in December.
Conclusion: The commonest case seen as well as commonest cause of death was cerebrovascular accident. A high number of heart failure, head injuries, road traffic accidents, upper gastrointestinal bleeding and post partum haemorrhage were also seen as common causes of death.The emergency physician must be well trained in skills required for the immediate management of patients with these cases.

Keywords: Accident, emergency, cases, deaths, cerebrovascular.