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

Adebusoye, Lawrence A.; Kalula, S Z

doi:10.7196/samj.2019.v109i2.13275

Cited by 9 publications

(12 citation statements)

References 12 publications

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“…In a systematic review of the literature on hospital mortality among older adults in medical services in Africa which included ve studies and 3,427 older adults from Nigeria, Senegal, Morocco and Kenya, 22.6% of deaths have been reported [26]. Also, in South Africa, out of 11,254 older adults admitted to medical services during a four-year period, 15.1% of deaths were reported [9]. Mortality among hospitalized older adults in Africa is higher than that reported in Europe and Asia [8,27,28], suggesting poor quality of health care for older adults.…”

Section: Discussionmentioning

confidence: 99%

“…Also, high mortality rates have been reported among hospitalized older adults, ranging from 5% during hospital stay to 20%-30% within one year following hospital discharge [7]. In the literature, main risk factors for hospital mortality among older adults are age, length of stay [9,10], health conditions such as cardiovascular diseases, diabetes, stroke, cancer, and lung diseases [10], and geriatric syndromes such as fall, inappropriate drug use, malnutrition, frailty, functional impairment, and depression [10][11][12][13][14][15][16][17]. Assessing these predictors is important as some of them can be prevented through appropriate interventions.…”

Section: Introductionmentioning

confidence: 99%

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Predictors of three-month mortality among hospitalized older adults in Togo

Gbeasor-Komlanvi

Tchankoni

Bakoubayi

et al. 2020

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Background: Assessing hospital mortality and its predictors is important as some of these can be prevented through appropriate interventions. Few studies have reported hospital mortality data among older adults in sub-Saharan Africa. The objective of this study was to assess the mortality and associated factors among hospitalized older adults in Togo.Methods: We conducted a prospective cohort study from February 2018 to September 2019 among patients ≥50 years admitted in medical and surgical services of six hospitals in Togo. Data were recorded during hospitalization and through telephone follow-up survey within 90 days after admission. The main outcome was all-cause mortality at 3 months. Survival curves were estimated using the Kaplan-Meier method and Cox regression analyses were performed to assess predictors of mortality.Results: The median age of the 650 older adults included in the study period was 61 years, IQR: [55-70] and at least one comorbidity was identified in 59.7% of them. The all-cause mortality rate of 17.2% (95%CI: 14.4-20.4) and the majority of death (93.7%) occurred in hospital. Overall survival rate was 85.5% and 82.8% after 30 and 90 days of follow-up, respectively. Factors associated with 3-month mortality were the hospital level in the health pyramid, hospitalization service, length of stay, functional impairment, depression and malignant diseases.Conclusion: Togolese health system needs to adjust its response to an aging population in order to provide the most effective care.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Predictors of three-month mortality among hospitalized older adults in Togo

Gbeasor-Komlanvi

Tchankoni

Bakoubayi

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Predictors of three-month mortality among hospitalized older adults in Lomé, Togo

Gbeasor-Komlanvi

Tchankoni

Bakoubayi

et al. 2020

Preprint

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Abstract Background: Assessing hospital mortality and its predictors is important as some of these can be prevented through appropriate interventions. Few studies have reported hospital mortality data among older adults in sub-Saharan Africa. The objective of this study was to assess the mortality and associated factors among hospitalized older adults in Togo.Methods: We conducted a prospective cohort study from February 2018 to September 2019 among patients ≥50 years admitted in medical and surgical services of six hospitals in Togo. Data were recorded during hospitalization and through telephone follow-up survey within 90 days after admission. The main outcome was all-cause mortality at 3 months. Survival curves were estimated using the Kaplan-Meier method and Cox regression analyses were performed to assess predictors of mortality.Results: The median age of the 650 older adults included in the study period was 61 years, IQR: [55-70] and at least one comorbidity was identified in 59.7% of them. The all-cause mortality rate of 17.2% (95%CI: 14.4-20.4) and the majority of death (93.7%) occurred in hospital. Overall survival rate was 85.5% and 82.8% after 30 and 90 days of follow-up, respectively. Factors associated with 3-month mortality were the hospital level in the health pyramid, hospitalization service, length of stay, cardiovascular diseases excluding stroke, functional impairment, depression and malignant diseases.Conclusion: Togolese health system needs to adjust its response to an aging population in order to provide the most effective care.

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“…Hospital, noting that a large proportion of deaths occurred within a few days of admission [19] . Onwuchekwa and Asekomeh reported a gross death rate of 26.7% in older persons admitted into medical wards in University of Port Harcourt Teaching Hospital between 2002 and 2006 [20] , whereas Adebusoye and Kalula however reported lower death rates (15%) in elderly patients admitted in a hospital in South Africa [21] . A much lower death rate of 4.6% was reported by Goh et.…”

Section: Sanya Et Al Reported a Death Rate Of 317% In Elderly Patiementioning

confidence: 99%

A Quality Assessment of Clinical Service Utilization in a Geriatrics Unit in West Africa: 2014-2018

Obehi¹,

Osian²,

B³

et al. 2020

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Background: Quality healthcare requires learning organizations who demonstrate commitment to evaluation and improvement. The Geriatrics Unit in the 850-bedded University of Benin Teaching Hospital (UBTH), Nigeria, was set up in 2014 to provide quality healthcare to older persons. The goal of this evaluation was to assess the extent to which that initiative met its objectives. Methods: Using the Donabedian's framework, we undertook a formative review of key service elements in the Geriatrics Unit of UBTH from April 1, 2014 to March 31, 2018, using data from routine ward documentation. Results: The unit had a multidisciplinary team of doctors, nurses, physiotherapists, occupational therapists, pharmacists, medical social workers and support staff throughout the period in focus. All records were manually kept. In-patient numbers more than doubled within the first year, from 62 to 133. Increasing utilization was also evident in bed occupancy rates that rose from 20.1% in 2014 to a peak that exceeded the maximum capacity of open beds (112%) in 2017, and required closed beds to be opened. Bed turnover rates increased from 3.7 in 2014 to 22.2 in 2017. The median average length of stay was 13.9 days. Gross mortality rate ranged between 23% and 31.8%; annual fall rates between 0.4 and 3.0 falls per thousand patient days, and discharges against medical advice (DAMA) between 0.8% and 6.1%.Conclusion: Multi-disciplinary care was maintained in the geriatrics unit, and available beds were oversubscribed within the 4 years reviewed. Opportunities for improvement include moving on to electronic patient records; increasing the number of functional beds; achieving lower mortality rates. Our findings also provide benchmarks against which future evaluations and quality improvement interventions will be measured.

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

Cited by 9 publications

References 12 publications

Predictors of three-month mortality among hospitalized older adults in Togo

Predictors of three-month mortality among hospitalized older adults in Togo

Predictors of three-month mortality among hospitalized older adults in Lomé, Togo

A Quality Assessment of Clinical Service Utilization in a Geriatrics Unit in West Africa: 2014-2018

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