Disease spectrum and outcomes among elderly patients in two tertiary hospitals in Dar es Salaam, Tanzania

• Published in: PloS one Vol. 14; no. 10; p. e0213131
• Main Authors: Tumaini, Basil, Munseri, Patricia, Pallangyo, Kisali
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 10.10.2019; Public Library of Science (PLoS)
• Subjects: Acquired immune deficiency syndrome; Activities of daily living; Aged; Aged, 80 and over; Aging; AIDS; Analysis; Cardiology; Cardiovascular Diseases - mortality; Cardiovascular Diseases - therapy; Chronic illnesses; Chronic kidney failure; Communicable diseases; Congestive heart failure; Demographics; Developing countries; Diabetes mellitus; Discharge; Elderly patients; Fatalities; Female; Geriatrics; Gerontology; Health aspects; Heart; Heart failure; Hospital admission and discharge; Hospital Mortality; Hospitals; Humans; Hypertension; Internal medicine; Internet; Kidney diseases; Kikwete, Jakaya Mrisho; LDCs; Length of Stay; Life expectancy; Malaria; Male; Management; Medical diagnosis; Medicine; Medicine and Health Sciences; Middle Aged; Mortality; Older people; Outcome and process assessment (Medical care); Patients; People and Places; Pneumonia; Pneumonia - mortality; Pneumonia - therapy; Population; Sociodemographics; Systematic review; Tanzania - epidemiology; Tertiary Care Centers; Tanzania; Africa
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0213131

There has been an increase in the number of individuals aged ≥60 years in Tanzania and in sub Saharan Africa in general due to improved survival. However, data is scarce on the disease burden and outcomes following admission in this population. We herein describe the pattern of diagnoses, outcomes and factors associated with the outcomes among elderly patients admitted at Muhimbili National Hospital (MNH) and Jakaya Kikwete Cardiac Institute (JKCI) medical wards. From October to December 2017, we consecutively enrolled patients aged ≥60 years (elderly) admitted to the MNH and JKCI medical wards. The ICD 10 was used to code for disease diagnosis at discharge or death. The Modified Barthel index was used to assess for functional activity on admission and at discharge. We enrolled 336 (30.1%) elderly participants out of 1301 medical admissions. The mean age ± SD was 70.6 ± 8.9 years; 169 (50%) were female and the average number of diagnoses was 2 per participant. The most common diagnoses were: hypertension 151 (44.9%), stroke 106 (31.5%), heart failure 62 (18.5%), pneumonia 60 (17.9%), diabetes mellitus 58 (17.3%) and chronic kidney disease 55 (16.4%). The median duration of hospital stay was 5 (IQR 3-10) days and in-hospital mortality was 86 (25.6%), 56 (65%) deaths were due to non-communicable diseases and 48 (55.8%) deaths occurred within 72 hours of hospitalization. A modified Barthel score ≤20 on admission was associated with an OR 15.43 (95% CI: 7.5-31.7, p<0.001) for death. Elderly patients constituted a significant proportion of medical admissions at MNH and JKCI with high in-hospital mortality. A modified Barthel index score ≤20 during admission is associated with mortality and can be used to identify patients requiring special attention.