President Umar Musa Yar’dua’s illnesses have at various times, been reported to involve different organs such as the lungs, heart, kidneys, circulatory, and central nervous system, all associated with Churg Strauss Syndrome (CSS). Yar’Adua has been in seclusion at an unknown location outside Nigeria, purportedly undergoing very intensive treatment for his ailments.
Our inability to get any reliable health status update on him has further intensified the grim assessments and speculations as well as calls for his resignation. This write up is intended to be short and informative to enable every average reader make their own permutations in the absence of truth from government and the ruling party.
There is a clinical condition called Multiple Organ Dysfunction Syndrome (MODS), defined as the presence of altered organ function in acutely ill patients such that homeostasis cannot be maintained without intervention. It usually involves two or more organ systems. Prognosis gets worse with increasing number of affected organs.
Outcome for patients with this condition is predicted using a model called the MODS score (1). The MODS score has been validated over the years and widely utilized in intensive care units (ICU). It is based on the function of six key organs, namely the pulmonary/lungs, kidney, heart, central nervous system, blood (platelet count) and liver. The organs thus far associated with Yar’Adua’s illness matched five out of these six organs relevant for determining MODS score and predicting survival. Depending on the functionality of the organ, a score of 0-4 points is assigned, with 0 representing essentially normal organ function and 4 a marked functional derangement. The maximum score attainable therefore for the six organs parameters is 24 points. A score of 9-12 points carries a mortality rate of ~25-50%. 13-16 points a mortality of ~50-70%, 17-20 points a mortality of ~75-82% and greater than 20 points is associated with a mortality of ~100% as show on table below.
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While there is uncertainty about the Yar’Adua’s health status, we are certain he has been away and in seclusion for more than 37 days. This, by most standards is a long hospital stay, consistent with management of a few severe conditions such as MODS, lung cancer, severe trauma, or coma. While he may well not have MODS as reports may suggest, and if he does, has good survival scores. However factoring in media reports, his known medical history, duration of current hospitalization or seclusion, secrecy and lack of credible information from family and government, one could feasibly see a pathway to the worst case scenario- a score of 21 and above. Should this be the case, the President would need every prayer as he would have gone beyond medical science salvage. Every government plans for a worst case scenario, even in the best of times more so when it is totally discredited and on the brink of collapse and anarchy. It is therefore a great disservice and even treasonable that the President and his government have kept the nation in darkness, lied about his actions, location and maybe health status. Most importantly our National security may have been compromised in a foreign country, with obvious strategic interest in Nigeria, by a seriously ill and vulnerable president. The leadership and members of the National Assembly have either been playing the Ostrich or chose to protect Yar’Adua to the detriment of our citizens and fragile democracy. They have shown zero diligence or courage in exerting their constitutional oversight role and as co-equal branch of government. They would be held equally accountable should the worst happens and the nation thrown into a constitutional crisis.
Given Yar”Adua’s frequent hospitalization history, sickly physical appearance, comatose and unraveling government, and suffering citizens I wish to, for his good and that of the country, once more call for his resignation and return to Katsina.
I wish him full and quick recovery, I hope he does same for the country.
Prof. Edward Oparaoji, PharmD, is a Cardio-Renal Specialist and Director with a leading Global Pharmaceutical Organization.
[email protected]
Ref:
1. Marschall JC et al. Multiple Organ Dysfunction Score : a reliable descriptor of a complex clinical outcome. Crit Care med.1995;23:1638-52
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