Gender Disparities In Mortality Among Medical Admissions Of A Tertiary Health Facility In Ilorin, Nigeria

Philip Manma Kolo; Adindu Chijioke

摘要

We retrospectively assessed sex-related differences in duration of hospital stay and mortality among medical admissions at the University of Ilorin Teaching Hospital (UITH), Nigeria between January 1996 and December, 2005. Seventeen thousand six hundred and fifty patients, consisting of 10,040 (56.9%) males and 7,610 (43.1%) females were admitted during the period under review. Of these, 4220 died which was made up of 2624 (62.2%) males and 1596 (37.8%) females with overall percentage mortality of 23.9%. Mortality rate was significantly higher (Chi2=62.5, p=0.0001) in males (26.1%) than in females (20.97%). The percentages of deaths due to Human Immunodeficiency Virus (HIV)/Tuberculosis (TB), neoplasms and haematological disorders were higher in females than in males (p=0.0001, 0.0001 and 0.0001 respectively). However, deaths from gastrointestinal system and liver, and endocrine system were higher in males (p=0.0001 and 0.02 respectively) than in females. We recommend gender specific community interventions for the control of HIV/AIDS, TB and liver diseases in the population studied. Introduction The risk of dying is known to differ for men and women in terms of age at and cause of death 1 . The gender disparities depend on the environment, level of economic development and some biological factors. Available statistics showed that the life expectancy of females at birth exceeds that of males by three years (66 versus 63) in developing countries and by 7 years (79 versus 72) in the developed nations of the world 12 . Although, women generally have a higher life expectancy at birth, there is the concern that women in third world countries are disadvantaged in terms of mortality 3 . The increase in mortality among women in developing countries has been attributed to poor access to health care services, economic depression and negative cultural practices 4 . In the developed world, longevity is higher in females because of high quality of obstetric care and lower coronary disease risk profile compared with males. However, in developing countries, the life expectancy gap is narrowed by unfavourable socio-cultural factors and high maternal deaths among women 5 .Recent population studies have shown that most developing regions of the world are undergoing gradual epidemiological transition resulting in high burden of both communicable and non-communicable diseases 6 . The duration of hospital stay has also been observed to be inversely related to the mortality rate in the medical wards 7 . Although, we have recently reviewed the causes of death in medical wards of our hospital 8 , but the influence of gender on the current trends in mortality among medical admissions has not been well defined. We therefore studied sex-differences in causes of death in the medical wards of UITH, Ilorin, Nigeria between January, 1996 and December, 2005 (ten years). Methods UITH, Ilorin is a tertiary health institution strategically located in the North-Central zone of Nigeria with bed capacity of 515. One hundred and ten of the bed spaces are dedicated to the medical admissions. In this retrospective study, information was obtained from hospital death register and case records of all patients who died during the period under review. The age, sex, occupation, principal diagnosis, duration of hospital stay, primary cause of death, type of previous treatment and post-mortem examination results were noted. The total number of admissions during the period was recorded. Most of the patients were referred either from private and/or government hospitals while some had self-referral or were brought by relatives in emergency situations. The data were analyzed using the SPSS statistical software version 15 and mean ± SD was generated for continuous variables. Student t-test was used to compare means of continuous variables while chi-square test was used to test significance of difference between two proportions. P-value of <0.05 was taken as a measure of statistic

机译：我们回顾性评估了1996年1月至2005年12月在尼日利亚伊洛林大学教学医院（UITH）入院的住院患者住院时间和病死率与性别相关的差异。1760例患者，包括10,040（56.9）在回顾期内，男性（％）和女性（7,610（43.1％））被录取。其中4220例死亡，其中男性2624例（62.2％）和女性1596例（37.8％），总死亡率为23.9％。男性（26.1％）的死亡率显着高于女性（20.97％）（Chi2 = 62.5，p = 0.0001）。女性死于人类免疫缺陷病毒（HIV）/结核病（TB），肿瘤和血液系统疾病的百分比高于男性（分别为p = 0.0001、0.0001和0.0001）。但是，男性的胃肠道系统和肝脏，内分泌系统的死亡率高于女性（分别为p = 0.0001和0.02）。我们建议针对所研究人群的针对性别的社区干预措施，以控制艾滋病毒/艾滋病，结核病和肝病。引言死亡的风险因年龄和死亡原因1而有所不同。性别差异取决于环境，经济发展水平和某些生物学因素。现有的统计数据表明，在发展中国家，女性出生时的预期寿命比男性高出三年（66岁对63岁），在世界发达国家中则比男性高出7岁（79岁对72岁）12。尽管妇女通常在出生时具有较高的预期寿命，但令人担忧的是，第三世界国家的妇女在死亡率方面处于不利地位3。发展中国家妇女死亡率的增加归因于难以获得保健服务，经济萧条和消极的文化习俗4。在发达国家，与男性相比，由于产科护理质量高，冠心病风险低，女性的寿命更长。但是，在发展中国家，不利的社会文化因素和妇女高产妇死亡率使预期寿命差距缩小5。最近的人口研究表明，世界上大多数发展中地区正在经历逐渐的流行病学转变，导致这两种传染病的负担都很高。和非传染性疾病6。还观察到住院时间与医疗病房的死亡率成反比7。虽然，我们最近回顾了我们医院医疗病房中的死亡原因8，但是性别对当前医疗住院死亡率趋势的影响尚未明确。因此，我们在1996年1月至2005年12月（十年）之间的尼日利亚伊洛林市UITH的医疗病房研究了死亡原因的性别差异。方法伊洛林（Ilorin）是一家三级医疗机构，战略性地位于尼日利亚的中北部地区，可容纳515人，可容纳119个床位。在这项回顾性研究中，信息来自于医院死亡登记簿和回顾期内所有死亡患者的病历记录。记录了年龄，性别，职业，主要诊断，住院时间，主要死亡原因，先前治疗的类型和验尸检查结果。记录了该期间的入学总数。大多数患者是从私立医院和/或政府医院转诊的，而有些患者会自行转诊或在紧急情况下由亲戚带来。使用SPSS统计软件15版分析数据，并为连续变量生成平均值±SD。学生t检验用于比较连续变量的均值，而卡方检验用于检验两个比例之间差异的显着性。 P值<0.05作为统计量度

Gender Disparities In Mortality Among Medical Admissions Of A Tertiary Health Facility In Ilorin, Nigeria

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