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

Abstract

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.

Internações hospitalares em idosos no extremo Norte do Brasil

“…Comportamentos pouco saudáveis como o sedentarismo e a dieta inadequada contribuem para esta prevalência 13 . Estudo realizado na Tanzânia demonstrou que as principais causas de internações em idosos foram a hipertensão arterial, o infarto e a insuficiência cardíaca, indicando uma ascendência das DCNT nesta população 14 . Pesquisa sobre a morbidade hospitalar em idosos no Brasil demonstrou a prevalência de doenças circulatórias, a redução das doenças infecciosas e parasitárias e uma indicação de aumento das neoplasias 10 .…”