Reasons for hospitalization, treatment outcome and predictors in adult diabetic patients at Jimma University Specialized Hospital, Southwest Ethiopia: A prospective observational study

Abstract

Diabetes Mellitus is a global public health problem, with the major increases in prevalence expected to occur in developing countries. It has been reported that diabetic patients had frequent hospitalization compared with non-diabetics and associated with increased morbidity, mortality and health care expenditure. Despite this, there is scarcity of data on hospitalization pattern and treatment outcome among diabetic patients in Ethiopia, particularly at Jimma University Specialized Hospital. Objective: The objective of this study was to assess reasons for hospitalization, treatment outcome and their predictors in adult diabetic patients at Jimma University Specialized Hospital Method: A hospital based prospective observational study was conducted at medical and surgical wards of Jimma University Specialized Hospital from February 21 to June 30, 2015. The study outcome variables were reason for hospitalization, treatment outcome and predictors. All adult patients with the diagnosis of diabetes who meet the inclusion criteria were included in the study. Data was collected using pretested abstracting format. Logistic regression was used to determine predictors of diabetes related hospitalization and treatment outcome by taking statistical significance of p<0.05. Result: A total of 89 patients admitted to medical (84.27%) and surgical (15.73%) wards were enrolled in the study, of which 59.55% were male, with the mean age 46.86±15.52 years. Type 2 diabetic patients accounted for 74.16%. One third (33.71%) of patients were hospitalized with diabetic ketoacidosis. Other common reasons for hospitalization were infections (19.10%) and cardiovascular diseases (17.98%). Duration of hospital stay ranged from 1 to 88 days, with median duration of 9 days. Seventy six percent of patients were discharged with improvement and in hospital mortality rate was 11.24% which was higher in patients admitted due to infections. Type 1 diabetes was found to be an independent predictor of diabetes related admissions (AOR=5.23, 95%CI: 1.36-20.11) while knowledge of complications (AOR=3.33, 95% CI: 1.22-9.09), insulin (AOR=4.55, 95%CI: 1.29-16.03) and enalapril (AOR= 5.78, 95%CI: 1.69-19.75) therapy before admission were inversely related with diabetes related admission. Diabetic related admission was an independent predictor of good treatment outcome (AOR=5.69, 95%CI: 1.42-22.90). Conclusion: In general, patients were commonly hospitalized due to diabetic complications primarily due to diabetic ketoacidosis. The other two common reasons for hospitalizations were infections and cardiovascular diseases. In hospital mortality was high in patients admitted with infections. Diabetic related admission independently predict outcome.