الملخص
The elderly are increasingly been hospitalised into medical wards in Nigeria and little information is currently available on this group of patients. The objective of this study was to describe the demographic, clinical characteristics and outcome of management of elderly patients admitted into medical wards at the University of Ilorin Teaching Hospital Ilorin, Nigeria.A retrospective study in which hospital records of patients admitted between years 2001 to 2004 were reviewed. Information obtained included gender, occupation, diagnosis, investigations, duration of stay and outcome management. A total of 4113 adults were admitted into the medical wards within the period under review. Of these, 456 were aged 60 years and above. The elderly patients accounted for 11.1% of total hospitalisation into the medical wards. The mean age of the patients was 69 ± 9 years with male: female ratio of 243:105. The 3 most common diagnoses were: hypertensive heart failure (HHF), 19%; cerebrovascular accident (CVA), 12%; and tuberculosis (TB), 11%. The mean duration of hospitalisation was 15.6±13.8days. Cases of mortality had significantly higher value of mean serum potassium, urea and creatinine, compared to those with favourable outcome and were eventually discharged home. A total of 192 patients (55.2%) were discharged home, while 109 (31%) died giving in-hospital mortality of 31.7%. Majority of the deaths (75%) occurred within 14 days of hospitalisation. Significantly higher number of patients died within the first seven days compared to those discharged (P<0.01). The mean duration of hospital stay was 15.6±13.8 days. Patients with favourable outcome spent a mean of 18.5±14.1days while cases of mortality had a mean of 10.4±8.8days in hospital before death. Geriatric patients constituted more than a tenth of total hospitalisation into UITH medical wards. They accounted for a significant proportion of inhospital mortality. Since a third of the death occurred within the first few days of admission, improvement in the management of acute medical cases especially in the elderly is urgent needed. This will ensure survival of greater number of patients and thus reduces mortality.
Keywords: Elderly patients, medical, hospitalisation, diagnosis, outcome
Résumé
Les vieillards sont croissement hospitalisés dans les hôpitaux Nigeria et peu information est disponible sur ce groupe de patients. L’objective de cette étude retropective était de décrire des registres de l’année 2001 á 2004 les caractéristiques démographiques, cliniques et le résultat des soins des vieillards malade admis au centre universitaire hospitalier d’Ilorin au Nigeria. Les informations obtenues inclus le gendre, l’occupation, le diagnostic, les investigations et la durée et les résultats des soins. Au total les registres de 4113 adultes admis étaient revus. 456 vieillards étaient âgés de plus de 60 ans et faisaient 11.1% des hospitalisation totale des vieillards a l’hôpital. La moyenne d’age des patients étaient de 69 ± 9 ans avec une proportion de male et femelle de 243 : 105. Les trois conditions les plus communes étaient l’hypertension cardiaque 19%, accident cerebrovasculaire 12% et la tuberculose 11%. La durée moyenne d’hospitalisation était de 15.6 ± 13.8 jours. Les cas de mortalité avaient significativement de valeur plus élevé du taux de sérum en potassium, urée et créatinine compare a ceux avec des résultats favorable et étaient déchargés pour leur maisons. Au total 192 patients (55.2%) étaient déchargés alors que 109(31%) mourraient donnant un taux de mortalité a l hôpital de 31.7%. La majorité des morts (75%) appariaient entre 14 jours d’hospitalisation. Les patients avec une bonne guérison passaient en moyenne 18.5 ± 14.1jours alors que les cas de mortaliteavaient une moyenne de 10.4 ± 8.8 jours dans l’hôpital avant le décès. Les patients gériatriques constituent plus du dixième de toute l’hospitalisation dans ce centre hospitalier universitaire d’Ilorin. Puisque le tiers des décès ont eu lieu dans la première semaine d’admission, l’amélioration des soins des cas acute particulièrement chez les vieillards est très nécessaire afin de augmenter la survie et réduire la mortalité.
Correspondence: Dr. Emmanuel O Sanya, Department of Medicine, University of Ilorin Teaching Hospital, PMB 1459, Ilorin, Nigeria. Email: emanuelosanya@yahoo.com
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