Patterns of Mortality Occurrence in a Cardiology Unit of a Low-Income Country: A Critical Analysis at the Yaoundé Central Hospital

Abstract

Background: In-hospital mortality is high in low-income countries. Currently, little is known in Cameroon concerning the characteristics of patients who die in cardiology units. Our objectives were to determine the in-hospital mortality rate; describe the general characteristics of death patients, and factors associated with mortality. Material and Methods: We conducted a retrospective cross-sectional study by reviewing the medical records of all patients admitted to the cardiology unit of the Yaoundé Central Hospital (CHY) between January 2018 andJanuary 2019. The files of all death patients were studied for socio-demographical, clinical and therapeutical variables. Bivariate analysis was conducted to order to check the association between independents variables and time of death. A p-value 0.05 was considered statistically significant. Results: A total number of 860 patients were admitted in the cardiology unit of CHY during the study period. Amongst the 860 patients admitted 78 had a fatal outcome, hence, an in-hospital mortality rate of 9.06%. The male gender was predominant amongst the deceased patients (n = 45). The mean age at death was 69 ± 15.19 years. The median time before death was 6 days and they ranged between 1 to 25 days. Hypertension was the most frequent comorbidity (65.4%). Stroke was the principal cause of admission (40.3%), whereas the main presenting complaint was dyspnea (26.9%). Before being admitted to the cardiology department, the majority of the deceased patients were from the emergency department. The major clinical sign of death was respiratory distress (39.74%). Shock on admission was the sole factor found to be associated with the mean time of death (p = 0.012). The patients with deep venous thrombosis compared to other diagnoses were less like to die early (r = 16, p = 0.016). Conclusion: The patient admitted in the cardiology unit of Yaoundé Central Hospital died mainly from stroke and the death is earlier when the patient has signs of shock on admission. These results emphasize the need for a good primary evaluation at the emergency room, to better manage patients with cardiovascular diseases in the cardiology ward.