Pattern and Outcome of Gynaecological Admissions at a Nigerian Tertiary Care Centre
AbstractContext: Hospital based data, when monitored over a period of time may help in evaluating changes in disease pattern and mortality, thus assisting health planners and policy makers to re-order their priority.
Objective: The main objective of this study is to review the gynaecological admissions and deaths over a fiveyear period.
Subjects and Methods: The case notes of all admissions and deaths on the gynaecological ward between January, 1996 and December 2000 were reviewed. Analysis were made of the various diagnoses and outcome, length of hospitalization, turn around period, number of patients per bed per year and bed occupancy.
Results: There were 803 admissions over the study period, out of which 429 (53.4%) were emergencies while 374 (46.6%) were electively admitted for surgery. Two hundred and seventy five (34.2%) patients had purely medical treatment while 528 (65.8%) had surgical management. There were 9 patients per bed per year with a turn around (turnover) of 11.5 days and bed occupancy of 64.3%. .Twenty five (3.1%) patients discharged themselves against medical advice and there were 23 (2.9%) deaths. The interval between admission and death ranged from 1 to 37 days with a mean of 9.5 ± 3.2 days. All the deaths occurred in the emergency group. Abortion accounted for 15.6% of total gynaecological admissions and was the commonest disease entity responsible for gynaecological admission. Mortality was highest for (malignant) neoplasms accounting for 56.5% of deaths. This was followed by infections, 43.5% with post abortal sepsis contributing as much as 30.4% of fatality.
Conclusion: The study recommends improvement of preventive strategies towards complications of early pregnancy especially abortion in the community and encourages better admission policy, provision of appropriate facilities and manpower to improve the hospital services.
Key Words: Pattern, outcome, gynaecological admissions, fatality.
[Trop J Obstet Gynaecol, 2004;21:52-55]
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