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Predictors of mortality among older patients in the medical wards of a tertiary hospital in Nigeria

  • Lawrence Adekunle Adebusoye
  • Mayowa Owolabi
  • Adesola Ogunniyi
Original Article
  • 13 Downloads

Abstract

Background

Older people face the biggest challenges in the overburdened healthcare services in Nigeria especially when hospitalized. There is no reliable data on the predictors of mortality in this population.

Aims

To determine the predictors of mortality among older patients on admission in the medical wards of University College Hospital, Ibadan.

Methods

Using a prospective cohort design, we investigated 450 patients (> 60 years) from the day of admission to death or discharge. Variables assessed included sociodemographic, family dynamics, lifestyle habits, healthcare utilization, quality of life, frailty, anxiety, depression, cognition, functional disability and anthropometric parameters. Kaplan–Meier method and Log-rank test were used to estimate and compare survival functions, respectively. Cox proportional hazard regression analysis was used to determine the predictors of mortality.

Results

The mean age of the subjects was 71.5 ± 8.0 years and 234 (52.0%) were females. Overall, there were 99 (22.0%) in-hospital deaths. The median survival time (MST) was 36.0 ± 3.0 days [females = 40.0 ± 3.5 days vs males = 31.0 ± 4.5 days (p < 0.001)]. There was a significant negative correlation between MST and age (r = − 0.931). Predictors of mortality on Cox’s proportional hazard regression analyses were male sex HR = 2.03 (95% CI 1.27–3.24), severe frailty HR = 2.07 (1.02–4.20), cognitive impairment HR = 1.90 (1.14–3.17) and having ≥ 5 morbidities HR = 1.94 (1.14–3.30).

Conclusion

There was a high mortality among older patients particularly the frail, male or those with multiple morbidities. Prompt and holistic management of morbidities and targeted interventions for cognitive impairment and frailty are needed to improve survival during hospitalization.

Keywords

Medical ward Mortality Older patients Predictors Nigeria 

Notes

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

The University of Ibadan/University College Hospital Institutional Ethical Review Board (UI/UCH ERB) approved this research (reference number: UI/EC/12/0092).

Informed consent

Informed consent was obtained from all individual participants included in this study.

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Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  1. 1.Chief Tony Anenih Geriatric CentreUniversity College HospitalIbadanNigeria
  2. 2.Department of Medicine, College of MedicineUniversity of IbadanIbadanNigeria

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