Mortality among Diabetes In-Patients in Port-Harcourt, Nigeria

Background: Diabetes mellitus is a major cause of mortality and morbidity among in-patients in Nigeria. It may result from the acute metabolic complications or from the inexorable effects of chronic complications in the major organ systems. Objectives: This study was to determine the death rates and causes of death among in-patients with diabetes at an urban tertiary hospital in Port-Harcourt. Materials and Methods: The medical records of patients admitted with diabetes mellitus into the medical wards of the University of Port Harcourt Teaching Hospital from 1995-2004 were reviewed. The sources of data were the ward admission, death registers, death certificates and medical records. The annual and overall fatality rates were calculated from the available data. Results: During the period under review, 6,574 patients were admitted into the medical wards. Out of these, 686 (10.4%) were due to diabetes and its complications. The diabetic patients comprised of 428 (62.4%) males and 258 (37.6%) females giving a M:F ratio of 1.7:1. One hundred and eighteen of the diabetic patients died giving a case fatality of 17.2%. The main causes of death were diabetic ketoacidosis (DKA) (21.2%), diabetic mellitus foot syndrome (DMFS) (19.5%) and renal failure (12.7%). Diabetic emergencies accounted for 39.8% of all deaths. Conclusion: Diabetes mellitus is a significant cause of medical admissions in Port-Harcourt. The case mortality is very high especially from acute metabolic causes. There is a need for improved management of diabetes in Nigeria.