All-cause mortality among elderly patients admitted to the medical wards of hospitals in Africa: A systematic review

Adebusoye, Lawrence A.; Owolabi, MO; Kalula, S Z; Ogunniyi, Adesola

doi:10.4103/1596-4078.171372

Cited by 16 publications

(29 citation statements)

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“…This study was conducted in a large tertiary hospital in SA and deaths were reported in almost one-sixth (15.1%) of older patients. This proportion of deaths was similar to that reported in a systematic review of in-hospital mortality among elderly patients in medical wards in Africa [5] and South America. [9] However, mortality was higher than that reported from Europe (8.4%).…”

Section: Discussionsupporting

confidence: 87%

“…Hospitalisation for medical illnesses is considered to be a risk factor for death among older persons. [5] Furthermore, such illness usually has adverse effects on health and may lead to negative outcomes such as disability, loss of independence and autonomy, and social isolation. In addition, older patients have increased susceptibility to iatrogenic conditions and nosocomial as well as other infections.…”

Section: Researchmentioning

confidence: 99%

“…In addition, older patients have increased susceptibility to iatrogenic conditions and nosocomial as well as other infections. [3] Research has shown that older patients accounted for 11.0 -56.6% of all adult hospital medical ward admissions, [5] with a mortality rate of 26.6 -57.6%. [5] In Africa, however, the mortality rate is expected to be higher owing to a lack of standard medical facilities.…”

Section: Researchmentioning

confidence: 99%

“…There is, however, a paucity of information on the mortality rate among hospitalised older patients in medical wards in Africa. Most of the existing information on older patients has been extracted or extrapolated from data on general adult patients admitted to medical wards in Africa, [5] which revealed higher levels of hospitalisation and mortality among older persons compared with the young population. [5,6] This study therefore sought to determine mortality rates, temporal trends and associated factors among older patients admitted in a large tertiary hospital in SA.…”

Section: Objectivesmentioning

confidence: 99%

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Mortality among older patients admitted to the medical wards of Groote Schuur Hospital, Cape Town, South Africa, 2010 - 2013

Adebusoye

Kalula

2019

S Afr Med J

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Mortality among older patients admitted to the medical wardsBackground. Geriatric medicine is an evolving specialty in Africa, and little is known about mortality among older patients admitted to medical wards. Objectives. To determine mortality rates and associated factors among older medical inpatients. Methods. Electronic data on patients aged ≥60 years admitted to the medical wards of Groote Schuur Hospital, Cape Town, South Africa, between January 2010 and December 2013 were analysed. Data extracted included sex, age, causes of death, and length of stay from date of admission to discharge or death. Results of laboratory tests carried out during the admission were also obtained. Results. In all, 11 254 older patients were admitted (mean (standard deviation) age 70.7 (7.9) years). There were 1 701 deaths (15.1%). The unadjusted mortality rate was 29.6 deaths per 1 000 patient-days (PD). The majority (87.5%) were admitted as emergency cases. Mortality in the first 24 hours was 32.4 deaths per 1 000 PD. There was a significant increase in mortality with increasing age (p<0.001). Stroke was the commonest cause of mortality (14.5%). The predictors of mortality were short length of stay on admission (odds ratio (OR) 1.047, 95% confidence interval (CI) 1.033 -1.061), high white blood cell count (OR 1.064, 95% CI 1.054 -1.074), low platelet count (OR 0.999, 95% CI 0.996 -1.000), low haemoglobin (OR 0.940, 95% CI 0.917 -0.964) and high blood urea (OR 1.042, 95% CI 1.033 -1.051). Conclusions. Mortality among older medical inpatients was high. Modifiable predictors of mortality, especially related to laboratory derangements, should be identified and addressed promptly.

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Section: Discussionsupporting

confidence: 87%

Section: Researchmentioning

confidence: 99%

Section: Researchmentioning

confidence: 99%

Section: Objectivesmentioning

confidence: 99%

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Mortality among older patients admitted to the medical wards of Groote Schuur Hospital, Cape Town, South Africa, 2010 - 2013

Adebusoye

Kalula

2019

S Afr Med J

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“…The observed in-hospital mortality of 25.6% is similar to that reported from other centers in Tanzania and other African countries [5,25]. However, the mortality was four times higher compared to in-hospital mortality in the United Kingdom [5].…”

Section: Discussionsupporting

confidence: 84%

Disease spectrum and outcomes among elderly patients in two tertiary hospitals in Dar es Salaam, Tanzania

Tumaini

Munseri

Pallangyo

2019

Preprint

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19Background 20 There has been an increase in the number of individuals aged ≥60 years in Tanzania and in sub 21 Saharan Africa in general due to improved survival. However there is scarcity of data on the 22 disease burden, patterns and outcomes following admission in this population. We therefore 23 describe the pattern of diagnoses, outcomes and factors associated with the outcomes among 24 elderly patients admitted at Muhimbili National Hospital (MNH) and Jakaya Kikwete Cardiac 25 Institute (JKCI) medical wards. Methodology27 We prospectively enrolled patients aged ≥60 years (elderly) admitted through MNH Emergency 28 Medicine to the MNH medical wards and JKCI. ICD 10 was used to code for disease diagnosis 29 at discharge or death. Modified Barthel index was used to assess for functional activity on 30 admission and at discharge. Results32 We enrolled 336 elderly participants, who comprised 30.1% of all medical admissions. The 33 mean age was 70.6 years; 50% were female and 263 (78.3%) had comorbidities with an average 34 of 2 diagnoses per participant. The most common diagnoses were: hypertension (44.9%), stroke 35 (31.5%), heart failure (18.5%), pneumonia (17.9%), diabetes mellitus (17.3%) and chronic 36 kidney disease (16.4%). The median duration of hospital stay was 5 days and in-hospital 37 mortality was 25.6%. Non-communicable diseases (NCDs) accounted for 65% of the deaths and 38 50% of the deaths occurred within 72 hours of hospitalization. A modified Barthel score of 20 39 on admission was associated with 15 times increased risk of death (p<0.001).Page 3 of 19 40 Conclusion 41 NCDs were the most common diagnoses and cause of death among patients aged ≥60 years 42 admitted to the medical wards. In-hospital mortality was high and occurred within 72 hours of 43 hospitalization. A modified Barthel score <20 on admission was associated with mortality.

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Predictors of mortality among older patients in the medical wards of a tertiary hospital in Nigeria

2018

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All-cause mortality among elderly patients admitted to the medical wards of hospitals in Africa: A systematic review

Cited by 16 publications

References 0 publications

Mortality among older patients admitted to the medical wards of Groote Schuur Hospital, Cape Town, South Africa, 2010 - 2013

Mortality among older patients admitted to the medical wards of Groote Schuur Hospital, Cape Town, South Africa, 2010 - 2013

Disease spectrum and outcomes among elderly patients in two tertiary hospitals in Dar es Salaam, Tanzania

Predictors of mortality among older patients in the medical wards of a tertiary hospital in Nigeria

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