Prevalence of and Characteristics Associated with In-Hospital Mortality in a Ugandan Neurology Ward

Abstract Background ― While the burden of neurologic illness in developing countries is increasing, less is known about mortality among patients admitted to sub-Saharan African hospitals with neurologic disease. We sought to characterize the rate and patient-level predictors of in-hospital mortality in a Ugandan Neurology ward.ccMethods ― Data was prospectively collected on 335 patients admitted to the Neurology ward of Mulago Hospital, Kampala, Uganda. Kaplan-Meier survival curves and multivariate COX proportional hazard modeling were used to assess survival.Results ―Within our sample (n=307), 35.8% received no diagnosis at time of hospital admission. Stroke (27.3%), head trauma (19.6%), and malaria (16.0%) were the most common diagnoses. Among the 56 (18.5%) patients who died during the index hospitalization, the most common diagnosis at admission and at death was stroke. Adjusted regression analysis showed that patients without a diagnosis at time of death (HR=7.01 [2.42-20.35], p<.001) and those with diagnoses of infections (HR=5.21 [2.16-12.58], p=<.001), stroke (HR=2.69 [1.20-6.04], p=.017), or head trauma (HR=3.39, [1.27-9.07], p=0.15) had worse survival. Conclusions ― In-hospital mortality affected nearly 20% of the cohort, with worse survival among those without a diagnosis and with infections, stroke, head trauma. Future work should identify reasons for increased mortality among these high-risk groups and implement targeted interventions.