Geriatric injuries among patients attending a regional hospital in Shinyanga Tanzania

Abstract

Geriatric injuries pose a major challenge to surgeons and general practitioners in developing countries. The objective of this study was to determine the prevalence, injury characteristics and outcomes of geriatric injury among patients at Shinyanga Regional Hospital in Tanzania. Data was collected using a pre-tested, coded questionnaire and analyzed using SPSS computer system. A total of 94 geriatric trauma patients constituting 22.7% of all trauma admissions were studied. The male to female ratio was 1.4:1. Their mean age was 68.5 years (ranged 60-98 years). Premorbid illness was reported in 38.3% of patients. Most injuries were intentional in fifty-three (56.4%) patients. Assaults, falls and road traffic crashes were the mechanism of injuries in 52.1%, 19.1% and 11.7% of cases, respectively. The majority of cases of assault were females accounting for 64.6%. The majority of injuries (81.9%) occurred at home. Pre-hospital care was recorded in 5.3% of cases. The musculoskeletal (72.3%) and head (66.0%) regions were commonly affected. Soft tissue injuries (wounds) (89.4%) and fractures (52.2%) were the most common type of injuries. The majority of patients (90.4%) underwent surgical treatment of which wound debridement was the most common procedure performed in 91.8% of cases. Complication rate was 39.4%. The mean length of hospital stay was 28.6 days (ranged 1 -124 days). The length of hospital stay was significantly longer in patients with co-morbidities, long bone fractures and those with complications (P<0.05). Mortality rate was 14.9% and it was significantly related to advanced age, presence of pre-morbid illness, high injury severity score, severe head injuries and the need for ventilatory support (P< 0.05). In conclusion, traumatic injuries in elderly constitute a major but preventable public health problem in Shinyanga region and contribute significantly to high morbidity and mortality. Urgent preventive measures focusing at the root causes of the injuries and early appropriate treatment is highly needed to reduce the occurrence, morbidity and mortality associated with these injuries. ____________________________________________________________________________________________

Injury Characteristics and Outcomes in Elderly Trauma Patients in Sub‐Saharan Africa

“…Saidi et al showed similar patterns of injury to our study with a comparable percent of elderly patients in their trauma population (4.5 vs. our 2.9 %) [11]. Chalya et al had different findings in neighboring Tanzania, where nearly 25 % of all patients were 60 years or older [12], They also had a very high rate of assault (52.1 vs. our 13.6 %) with an associated increase in upper extremity injuries. Their high assault rate compared to our study and Saidi's report is likely explained by local socioeconomic factors.…”

“…There is a paucity of data on the characteristics and outcomes of the elderly trauma patient in sub-Saharan Africa. A few studies have been published, mostly with very small cohorts of elderly patients and most without comparison to younger patients [11][12][13][14][15]. The most relevant studies were from neighboring Tanzania and Kenya.…”

“…While traumatic injury in the elderly has been well described in high-income countries, very little data on elderly trauma have been published from sub-Saharan Africa [11][12][13][14][15]. To address this gap, we evaluated the common mechanisms, patterns of injury, and outcomes associated with elderly trauma patients compared to other adult trauma patients presenting to our tertiary trauma center in Lilongwe, Malawi.…”

Epidemiology and outcomes of geriatric trauma patients consulting at the center hospitalier universitaire de Kigali emergency department

“…Geriatric trauma, most commonly defined as trauma affecting patients aged 65 and older, is an emerging global problem [ 1 , 2 ]. Elderly trauma patients suffer increased morbidity and mortality that can be attributed to age, pre-existing disease, complications, injury severity, and their unique physiology, behavior, and anatomy [ 3 , 4 ]. Consequently, medical and surgical resource needs for their injuries are disproportionately greater than for the same injuries in younger patients [5] .…”

“…Consequently, medical and surgical resource needs for their injuries are disproportionately greater than for the same injuries in younger patients [5] . Outcomes of geriatric trauma patients may be especially poor in developing countries, where the lack of advanced pre-hospital care systems and trauma centres hinder optimal trauma care [ 3 , 4 , 6 ]. Existing studies on trauma in Malawi have found increased mortality among elderly patients compared to.…”