Morbidity pattern and illness severity among older patients admitted to the medical wards of a Tertiary Hospital in Nigeria
AbstractBackground: Acute exacerbation of chronic illnesses often leads to hospitalization and possible mortality among older persons. Few data exist on the burden of medical morbidities among hospitalized older Nigerians.
Objectives: To describe the morbidity pattern of older patients admitted to the medical wards of University College Hospital, Ibadan.
Methods: This was a prospective study from the day of admission to death or discharge of 450 older patients aged 60 years and above. The International Classification of Primary Care (ICPC) diseases format was used to categorize the morbidities and cumulative illness rating scale for geriatrics (CIRS-G) was used to determine the illness severity. Bivariate and multivariate analyses were carried out and p value was set at <0.05.
Results: There were 234 (52.0%) females and mean age was 71.5±8.0 years. Overall, the mortality rate was 22.0%. There were 3.2 diagnoses per respondent (range 1-10). Hypertension (59.1%) and diabetes mellitus (38.4%) were the most prevalent diseases. Noncommunicable diseases accounted for 80.4% of the diagnoses. Multimorbidity (≥2 diagnoses) was found in 87.3%. Illness severity was highest in the cardiac system (72.6%) and lowest in the psychiatric system (4.8%). The mean illness severity score (9.2 ± 4.7) was significantly associated with mortality, p=0.01. Predictors of mortality on logistic regression analyses were ischemic heart disease OR=2.526 (1.399–4.562), increased illness severity score OR=1.058 (1.004-1.115) and having ≥ 5 diagnoses OR=1.976 (1.124–3.474).
Conclusion: The high level of illness severity in this setting calls for a prompt assessment of morbidities among older patients at admission to reduce mortality.