Adolescent medical emergencies: baseline survey in a Nigerian tertiary hospital

Abstract

Background: Globally, there is dearth of data on non-traumatic adolescent medical emergencies, with most studies focussing on adolescent traumatic, psychotic and obstetric emergencies. There is need for extension of focus to this neglected area, especially in Africa where differences in lifestyle, perception and socioeconomic status may influence adolescent health.

Objective: To describe the morbidity pattern of adolescents admitted as medical emergencies in a Nigerian tertiary hospital and to identify factors that correlate with mortality amongst them.

Methodology: This was a prospective study of all adolescents aged 10 to 19 years consecutively admitted into the Children Medical Emergency Ward of a Nigerian tertiary hospital, over a 2 year period. Their bio-data, clinical condition at time of presentation and outcome at discharge from the emergency room were documented. Bivariate analysis for correlation of these factors with mortality was done utilizing the Statistical Package for Social Sciences version 20.

Results: Two hundred and two adolescents were admitted in the emergency room within the period. Their mean age was 13.3 +2.3 years with male to female ratio of 1.5:1. The major presenting symptom was fever with the predominant disease category being infectious and parasitic diseases in 31.2% of them. A sickle cell disease crisis was responsible for 15% of admissions and was the commonest single disease entity amongst them. The mortality rate was 6.4%. Acute exacerbations of chronic diseases were responsible for 85% of the mortalities. Chronic kidney disease with case fatality of 36% was significantly correlated with mortality [OR 8.4 CI 3.2-22.3]. Gender, age and maternal educational status had no significant correlation to the outcome.

Conclusion: Acute exacerbation of chronic medical conditions account for poor outcome of medical emergencies in adolescents in the study centre. This calls for intensification of Preventive Medicare and adoption of the principle of pro active follow up of adolescents living with chronic diseases.

Keywords: Non-traumatic, Acute exacerbations, Chronic diseases, Outcome