Highlights
- •To our knowledge this is the first study to compare long term outcomes in the developed and developing country.
- •The 7, 30 and 60 days mortality of Ugandan and Danish acutely ill medical patients were compared.
- •More Ugandan than Danish patients died within a week, 30 days and 60 days of admission.
- •Severe derangements in breathing rate and blood pressure were more common in Ugandan patients.
- •Danish patients were more likely to have severely deranged oxygen saturations.
- •Patients without severely deranged vital signs or able to stand unaided had the same outcomes.
Abstract
Background
The outcomes of patients with the same severity of illness in the developed and developing
countries have not been compared. Illness severity can now be measured anywhere by
the National Early Warning Score (NEWS).
Methods
An exploratory observational study that compared the 7, 30 and 60 days mortality of 195 Ugandan and 588 Danish acutely ill medical patients that had
a NEWS >6 at the time of their admission to the hospital. The association of vital sign changes,
alertness and mobility at admission on subsequent outcome was explored.
Results
More Kitovu (34.4%) than Danish patients (22.1%) died within 60 days of admission (OR 1.85, 95% CI 1.27–2.71, p 0.001). However, the survival of non-comatose patients admitted without severely
deranged vital signs or who were able to stand without help was identical in both
cohorts (Chi square 0.32, p 0.57): these patients made up 50% of all Ugandan and 60% of all Danish patients.
In contrast the survival curves of patients admitted in a coma were widely divergent
within a week of hospital admission and remained so for a further 60 days (Chi square 10.29, p 0.001).
Conclusion
This small hypothesis generating observational study with huge selection and treatment
bias found no survival difference at 60 days after admission to resource rich and resource poor hospitals for patients without
severely deranged vital signs or who were able to stand without help.
Keywords
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Article info
Publication history
Published online: December 08, 2015
Accepted:
November 23,
2015
Received in revised form:
November 18,
2015
Received:
September 28,
2015
Identification
Copyright
© 2015 European Federation of Internal Medicine. Published by Elsevier Inc. All rights reserved.
