Diseases mortality patterns in elderly patients: A Nigerian teaching hospital experience in Irrua, Nigeria

Abstract

Background:Currently, in developing countries, there is a paradigm shift in the mortality patterns from communicable to non-communicable diseases.Objective:This study is aimed at providing a broad spectrum on the mortality patterns in elderly within a 5-year-period in a tertiary healthcare provider in Nigeria.Materials and Methods:This study is a retrospective review of mortality patterns of elderly patients from January 2007 to December 2011 occurring in Irrua specialist teaching hospital, (ISTH), Irrua and its environs. Information derived from the request cards include age, sex, clinical history, diagnosis, duration and cause of death.Results:During this period a total of 3,002 elderly (>65 years) admissions were seen. Of this, 561 patients were confirmed dead. Among this, 317 and 244 cases were elderly male and female patients, respectively. Hence the ratio of male to female was 1.3:1.0. The peak age group was 65-70 years accounting for 147 patients (26.2%). The age range of patients was 65-104 years while the modal and mean ages were 69 years and 74 years ΁ 4.2 standard deviation (SD), respectively. The most commonly encountered cause of mortality was cerebrovascular accident constituting 141 (25.1%) cases. The 2nd and 3rd majority of mortality cases were malignancies and diabetes mellitus (metabolic disorder) accounting for 85 (15.2%) and 45 (8%) cases, respectively. Others include congestive cardiac failure 35 (6.2%), Septicaemia 29 (5.2%), trauma 26 (4.6%) while chronic renal failure and chronic obstructive pulmonary disease consist of 22 cases (3.9%) each.Conclusion:Non-communicable diseases particularly cerebrovascular diseases and malignancies were the most commonly encountered cause of elderly mortality in our environment. Notwithstanding a large percentage of mortality patterns also results from communicable diseases with sepsis as the leading cause of mortality.

Clinical Conditions of Hospitalized Older Adult Patients and Their Outcomes in a Regional Referral Hospital in Southwestern Uganda

“…In the outcome analysis, this study observed an in-hospital mortality rate of 24.2% while 68.9% were discharged. Our findings on mortality is much higher than 8.5%, 12%, 16.4%, and 14.9% previously reported in Turkey, Portugal, Brazil, and Italy [ 16 – 19 ] in a similar population but close to what was observed in Nigeria (18.7%) within a related teaching hospital [ 20 ]. Again, our findings are the first to show such a high mortality in this population and require deeper investigations in future studies.…”

“…Indeed, the WHO predicts that by 2020, noncommunicable diseases such as heart disease, cancer, and diabetes will be among the main causes of mortality in the African region [ 21 ]. Already high incidences of cerebrovascular accident (25.1%) have been reported predominantly besides malignancies (15.2%), diabetes mellitus (8%), and congestive cardiac failure (6.2%) [ 20 ]. Others include septicemia (5.2%), trauma (4.6%), renal failure and chronic obstructive pulmonary disease (3.9%).…”

Medical mortality in an emergency department in Nigeria: the transition is obvious!

“… 4 This change will have a direct impact on the pattern of admission in the medical ED, and by extension the pattern of mortality. With the obvious paradigm shift from communicable to non-communicable diseases in developing countries 5 – 8 , the impact of epidemiological transition and the response by health care providers can be further assessed by reviewing medical mortality in health care facilities, especially the ED 2 , 6 . Two previous studies from our center had looked at acute medical deaths (death within 24 hours) in the emergency, Ajuluchukwu et al 9 , and hypertension-related complications of acute mortality, Mbakwem etal 10 heralding the impact of epidemiological transition.…”