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

BACKGROUND: Geriatric medicine is an evolving specialty in Africa, and little is known about mortality among older patients admitted to medical wardsOBJECTIVES: To determine mortality rates and associated factors among older medical inpatientsMETHODS: Electronic data on patients aged &gt;60 years admitted to the medical wards of Groote Schuur Hospital, Cape Town, South Africa, between January 2010 and December 2013 were analysed. Data extracted included sex, age, causes of death, and length of stay from date of admission to discharge or death. Results of laboratory tests carried out during the admission were also obtainedRESULTS: In all, 11 254 older patients were admitted (mean (standard deviation) age 70.7 (7.9) years). There were 1 701 deaths (15.1%). The unadjusted mortality rate was 29.6 deaths per 1 000 patient-days (PD). The majority (87.5%) were admitted as emergency cases. Mortality in the first 24 hours was 32.4 deaths per 1 000 PD. There was a significant increase in mortality with increasing age (p<0.001). Stroke was the commonest cause of mortality (14.5%). The predictors of mortality were short length of stay on admission (odds ratio (OR) 1.047, 95% confidence interval (CI) 1.033 - 1.061), high white blood cell count (OR 1.064, 95% CI 1.054 - 1.074), low platelet count (OR 0.999, 95% CI 0.996 - 1.000), low haemoglobin (OR 0.940, 95% CI 0.917 - 0.964) and high blood urea (OR 1.042, 95% CI 1.033 - 1.051CONCLUSIONS: Mortality among older medical inpatients was high. Modifiable predictors of mortality, especially related to laboratory derangements, should be identified and addressed promptly

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Main Authors: Adebusoye,L A, Kalula,S &#918;
Format: Digital revista
Language:English
Published: South African Medical Association 2019
Online Access:http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742019000200017
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spelling oai:scielo:S0256-957420190002000172019-03-12Mortality among older patients admitted to the medical wards of Groote Schuur Hospital, Cape Town, South Africa, 2010 - 2013Adebusoye,L AKalula,S &#918;BACKGROUND: Geriatric medicine is an evolving specialty in Africa, and little is known about mortality among older patients admitted to medical wardsOBJECTIVES: To determine mortality rates and associated factors among older medical inpatientsMETHODS: Electronic data on patients aged &gt;60 years admitted to the medical wards of Groote Schuur Hospital, Cape Town, South Africa, between January 2010 and December 2013 were analysed. Data extracted included sex, age, causes of death, and length of stay from date of admission to discharge or death. Results of laboratory tests carried out during the admission were also obtainedRESULTS: In all, 11 254 older patients were admitted (mean (standard deviation) age 70.7 (7.9) years). There were 1 701 deaths (15.1%). The unadjusted mortality rate was 29.6 deaths per 1 000 patient-days (PD). The majority (87.5%) were admitted as emergency cases. Mortality in the first 24 hours was 32.4 deaths per 1 000 PD. There was a significant increase in mortality with increasing age (p<0.001). Stroke was the commonest cause of mortality (14.5%). The predictors of mortality were short length of stay on admission (odds ratio (OR) 1.047, 95% confidence interval (CI) 1.033 - 1.061), high white blood cell count (OR 1.064, 95% CI 1.054 - 1.074), low platelet count (OR 0.999, 95% CI 0.996 - 1.000), low haemoglobin (OR 0.940, 95% CI 0.917 - 0.964) and high blood urea (OR 1.042, 95% CI 1.033 - 1.051CONCLUSIONS: Mortality among older medical inpatients was high. Modifiable predictors of mortality, especially related to laboratory derangements, should be identified and addressed promptlySouth African Medical AssociationSAMJ: South African Medical Journal v.109 n.2 20192019-02-01journal articletext/htmlhttp://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742019000200017en
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country Sudáfrica
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language English
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author Adebusoye,L A
Kalula,S &#918;
spellingShingle Adebusoye,L A
Kalula,S &#918;
Mortality among older patients admitted to the medical wards of Groote Schuur Hospital, Cape Town, South Africa, 2010 - 2013
author_facet Adebusoye,L A
Kalula,S &#918;
author_sort Adebusoye,L A
title Mortality among older patients admitted to the medical wards of Groote Schuur Hospital, Cape Town, South Africa, 2010 - 2013
title_short Mortality among older patients admitted to the medical wards of Groote Schuur Hospital, Cape Town, South Africa, 2010 - 2013
title_full Mortality among older patients admitted to the medical wards of Groote Schuur Hospital, Cape Town, South Africa, 2010 - 2013
title_fullStr Mortality among older patients admitted to the medical wards of Groote Schuur Hospital, Cape Town, South Africa, 2010 - 2013
title_full_unstemmed Mortality among older patients admitted to the medical wards of Groote Schuur Hospital, Cape Town, South Africa, 2010 - 2013
title_sort mortality among older patients admitted to the medical wards of groote schuur hospital, cape town, south africa, 2010 - 2013
description BACKGROUND: Geriatric medicine is an evolving specialty in Africa, and little is known about mortality among older patients admitted to medical wardsOBJECTIVES: To determine mortality rates and associated factors among older medical inpatientsMETHODS: Electronic data on patients aged &gt;60 years admitted to the medical wards of Groote Schuur Hospital, Cape Town, South Africa, between January 2010 and December 2013 were analysed. Data extracted included sex, age, causes of death, and length of stay from date of admission to discharge or death. Results of laboratory tests carried out during the admission were also obtainedRESULTS: In all, 11 254 older patients were admitted (mean (standard deviation) age 70.7 (7.9) years). There were 1 701 deaths (15.1%). The unadjusted mortality rate was 29.6 deaths per 1 000 patient-days (PD). The majority (87.5%) were admitted as emergency cases. Mortality in the first 24 hours was 32.4 deaths per 1 000 PD. There was a significant increase in mortality with increasing age (p<0.001). Stroke was the commonest cause of mortality (14.5%). The predictors of mortality were short length of stay on admission (odds ratio (OR) 1.047, 95% confidence interval (CI) 1.033 - 1.061), high white blood cell count (OR 1.064, 95% CI 1.054 - 1.074), low platelet count (OR 0.999, 95% CI 0.996 - 1.000), low haemoglobin (OR 0.940, 95% CI 0.917 - 0.964) and high blood urea (OR 1.042, 95% CI 1.033 - 1.051CONCLUSIONS: Mortality among older medical inpatients was high. Modifiable predictors of mortality, especially related to laboratory derangements, should be identified and addressed promptly
publisher South African Medical Association
publishDate 2019
url http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742019000200017
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