Incidence and impact of hospital-acquired complications in an internal medicine unit of a reference hospital in Cameroon: a prospective cohort study. (18th November 2020)

• Record Type: Journal Article
• Authors: Sih, Colette; Mbatchou-Ngahane, Bertrand Hugo; Mboue-Djieka, Yannick; Ngueng-Eke, Marie C; Mbarga, Nicole T; Verla, Vincent S; Choukem, Simeon-Pierre
• Is Part Of: Transactions of the Royal Society of Tropical Medicine and Hygiene. Volume 115:Number 7(2021)
• Page Start: 772
• Page End: 778
• Publication Date: 2020-11-18
• Subjects: direct medical costs -- hospital-acquired complications -- incidence -- length of stay -- risk factors -- sub-Saharan Africa; Tropical medicine -- Periodicals; 616.9883
• DOI: 10.1093/trstmh/traa116
• Languages: English
• ISSNs: 0035-9203

Abstract

Abstract: Background: Hospital-acquired complications (HACs) contribute to increased morbidity, mortality and hospital costs. However, their burden is often overlooked in resource-limited settings. We sought to determine the incidence, risk factors and effects of HACs on direct medical costs. Methods: This was a prospective cohort study conducted in the Internal Medicine inpatient ward of Douala General Hospital over 3 mo. Patients were examined daily from admission to discharge, transfer or death. Incidence of HACs was calculated and risk factors of HACs were determined using univariate and multivariate regression models. Results: The cumulative incidence rate of HACs in 230 participants was 29.2/1000 patient-days. The incidence rate of infectious and non-infectious complications was 8.4/1000 and 20.9/1000 patient-days, respectively. The most common HAC was constipation (8.3/1000 patient-days). The most common infection was urinary tract infection (3.7/1000 patient-days). HIV infection and length of stay >8 d were significantly associated with the occurrence of HACs. Deep vein thrombosis was associated with the highest direct medical cost. Conclusion: The incidence of HACs is high in our setting and leads to increased length of hospital stays as well as greater direct medical costs. Thus, there is a need for effective preventive strategies.