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 wards.
Objectives. To determine mortality rates and associated factors among older medical inpatients.
Methods. Electronic data on patients aged ≥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 obtained.
Results. 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 - 1.051).
Conclusions. Mortality among older medical inpatients was high. Modifiable predictors of mortality, especially related to laboratory derangements, should be identified and addressed promptly.
Copyright remains in the Author’s name. The work is licensed under a Creative Commons Attribution - Noncommercial Works License. Authors are required to complete and sign an Author Agreement form that outlines Author and Publisher rights and terms of publication. The Agreement form should be uploaded along with other submissions files and any submission will be considered incomplete without it [forthcoming].
Material submitted for publication in the SAMJ is accepted provided it has not been published or submitted for publication elsewhere. Please inform the editorial team if the main findings of your paper have been presented at a conference and published in abstract form, to avoid copyright infringement. The SAMJ does not hold itself responsible for statements made by the authors.
Previously published images
If an image/figure has been previously published, permission to reproduce or alter it must be obtained by the authors from the original publisher and the figure legend must give full credit to the original source. This credit should be accompanied by a letter indicating that permission to reproduce the image has been granted to the author/s. This letter should be uploaded as a supplementary file during submission.