Factors associated with mortality among inpatients at Koidu Government Hospital, Sierra Leone: A Secondary data analysis

Introduction: Sierra Leone's life expectancy in 2019 was 61 years, below the average for low-income African countries. This study aimed to determine factors associated with morbidity and mortality among inpatients at Koidu Government Hospital (KGH), addressing limited data on hospital outcomes in Sierra Leone. Methods: A retrospective cross-sectional study analyzed KGH inpatient data from 2020-2022, examining admission details, demographics, and primary death causes using ICD-11 coding. MS Excel software was used to calculate percentages and ratios. Bivariate and multivariate analysis to assess the association between independent variables and outcome variable. Epi-info was used to calculate adjusted Odd Ratio (aOR) at 95% confidence interval (CI). Results: A total of 48,579 admissions of which 9.4% (4,589) deaths were recorded. The mean age of inpatients who died was 43 ± 19.40 years and patients admitted was 18.4 ± 17.65 years. The annual mortality rate per 10,000 inpatient admission was 33, 39 and 32 in 2020, 2021, and 2022, respectively. Major contributors to inpatient admissions were malaria 34.4%, (16,687/48,579), respiratory diseases 7.9%, (3,841/48,579), and anemia 7.3% (3,546/48,579). Male patients (aOR=0.3, 95% CI: 0.253-0.301, p-value <0.001); inpatients aged less than 15 years (aOR =12.4 95% CI: 9.58- 16.06), p-value<0.001 extended hospital stay of more than 5 days (aOR= 12.4 95% CI: 9.58 - 16.06, p-value<0.001); and primary education (aOR= 53.1, 95% CI: 42.62 - 66.23, p-value<0.001); were independently associated with inpatient mortality. Conclusion: Malaria, respiratory diseases, and anemia were identified as a leading cause of admission among inpatients at Kono Government Hospital. Risk factors for mortality included being female, under 15 years of age, long hospital stays, and having lower education levels, prompting recommendations for strengthened health system and prevention and control of communicable diseases.