Predictive factors for special care units admission and in-hospital mortality among geriatric patients that presented to the emergency department of a teaching hospital

Abstract

Background: The world population is experiencing ageing and this phenomenon certainly gives significant impact to the social, economic as well as health care services globally. Objectives: This study aimed to determine the prevalence of geriatric patients treated in critical zone in an emergency department of a teaching hospital and the factors associated with special care units admission and in-hospital mortality. Methods: A single-centre prospective cross-sectional study was carried out from 1 January 2016 to 31 December 2016 at the Emergency Department Hospital at Universiti Sains Malaysia, Malaysia. All patients aged 60 years and above were included. Systematic random sampling was used. Variables were analysed using simple and multiple logistic regressions. Results: The total number of patients included in this study was 328, 55.8% were male and the mean age was 70.6 (standard deviation: 7.5) years. The commonly presenting diseases in this study were cardiovascular (31.4%), infectious (29.6%), neurological (14.9%) and respiratory (12.5%). Out of the 328 patients studied, 187 (57.0%) were admitted to general wards and 110 (33.5%) to special care units. A total of 55 patients (16.8%) succumbed within the period of in-hospital treatment. The factors associated with special care units admission were the usage of non-invasive ventilation and the administration of inotropic support. The factors associated with in-hospital mortality were blood urea level, serum albumin level and the application of mechanical ventilation. Conclusion: Geriatric patients who presented to emergency department requiring ventilator and inotropic support had been observed to exhibit worse outcome. The associated factors for special care units admission and in-hospital mortality had been identified, and this will enable better settings cater to the needs for critically ill geriatric patients.

A Clinical and Demographic Profile of Elderly (>65 Years) in the Medical Intensive Care Units of a Tertiary Care Center

“…The requirement of vasopressors in elderly ICU patients is significantly associated with poor outcomes in this study, which is in agreement with earlier reports. 2 , 6 , 24 , 26 – 28 The mortality rate for intubated patients was 28.7%, whereas previous published reports reported mortality rates ranging from 20.3 to 51%. 25 Previous research has shown that the intubation and receipt of mechanical ventilation were associated with increased mortality in elderly ICU patients.…”

“… 25 Previous research has shown that the intubation and receipt of mechanical ventilation were associated with increased mortality in elderly ICU patients. 2 , 5 , 13 , 26 – 28 …”