Cardiovascular diseases (CVDs) patients’ in-hospital mortality rate and length of hospital stay in Swaziland: 2001-2013

Background: Cardiovascular diseases (CVDs) are one of the leading non-communicable diseases (NCDs). A global analysis reveals that some of the poorest countries in the world have among the highest age-standardized mortality rates of CVDs. They are the leading cause of death globally. An estimated 17.5 million people died from CVDs in 2012, representing 31% of all global deaths [1]. Objectives: 1. Calculate and analyze the trend of in-hospital mortality rate of CVDs patients in public health facilities over a period of 13 years 2. Analyze the trend of length of hospital stay of patients with CVDs. 3. Analyze the association between the CVDs mortality and the independent variables (gender, age, and region). 4. Analyze the association between the length of hospital stay and independent variables Methods: Government data from 21 health facilities that offer in-patient services all over Swaziland was analyzed. Data for Cardiovascular Disease (CVD) in-patients, from 2001 to 2013, was used for the purpose of this study. 17809 patients were admitted for CVDs in the above-mentioned timeline and of those, there were 2955 in-hospital deaths. The study focuses on the CVD deaths. The association between outcome variables and the patients’ independent variables. Trend analysis on in-hospital CVD mortality and length of stay (LOS) over the 13 year period. Results: There was a significant rise on the CVD deaths over the years (p= 0.007). More patients are being admitted and the deaths also increase. For the LOS, there was no significant increase or decrease over the years. Region (urbanization) was found to be a significant variable for all outcome variables, i.e. CVD mortality, LOS and Discharge status with p= 0.01, 0.011 and 0 respectively. CVD mortality was also dependent on gender. There were significantly more female cases than males. Conclusion: Different studies, including this one, have shown that CVDs together with other non-communicable diseases are on the rise in lower middle income countries (LMIC) like Swaziland. The country has been plagued by the double burden of infectious diseases and NCDs. A lot of work has been done in combating most infectious diseases, more attention through government intervention policies, should be afforded to these NCDs.