Sanya Emmanuel O, Abiodun Alfred A, Kolo Philip, Olanrewaju Timothy O, Adekeye Kehinde
Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria.
Ann Afr Med. 2011 Oct-Dec;10(4):278-83; discussion 283-4. doi: 10.4103/1596-3519.87043.
Old age is one of the factors associated with increased risk of dying when admitted to hospital. Therefore, aim of this study was to examine causes and pattern of death among elderly patients managed in a tertiary care hospital in Nigeria with scanty mortality records.
This prospective study was on deaths that occurred in patients 60 years and above admitted to University of Ilorin Teaching Hospital (UITH), Ilorin, between January 2005 and June 2007. Excluded were all brought-in-dead during the study period. Information obtained included demographic data, duration on admission, and diagnosis. Causes of death were determined from clinical progress notes and diagnosis.
A total of 1298 deaths occurred during the study period, of which 297 occurred in persons 60 years and above with crude death rate of 22.8%. The mean age at death was 68 ± 9 years (ranged 60-100 years). This consisted of 59% males and 41% females. Mean age at death for females was 69.7 ± 8.7 years and for males 68.1 ± 9.8 years (P = 0.05). Mean values of serum chemistry were sodium 137 ± 8 mMol/l, potassium 3.6 ± 1 mMol/l, urea 11 ± 8 mMol/l, and creatinine 126 ± 91 μmol/l. The value of mean haemogram concentration was 10.5 ± 3 gm/dl and white cell count was 12 ± 2 × 10(9)/mm3. The three most common diagnoses at deaths were stroke (19.8%), sepsis (16.5%), and lower respiratory tract disease (8.1%). Infectious diseases accounted for 38.2% of all diagnoses. Collective mean length of hospital stay (LOS) at death was 6.8 ± 8.6 (ranged 15 minutes-60 days). Close to 27.4% of the deaths occurred within 24 hours and neurological disorder had shortest hospital stay (4.6 ± 6.3 days), followed by endocrine disorders (6.8 ± 8.4 days) and respiratory diseases (8.4 ± 5.6 days) [P = 0.001].
Hospital mortality is high amongst older people. Stroke and infectious diseases are leading causes of death. Efforts should be geared toward reducing risk for cardiovascular diseases and improvement on level of personal and community hygiene.
老年是入院时死亡风险增加的相关因素之一。因此，本研究的目的是调查在尼日利亚一家死亡率记录稀少的三级医院接受治疗的老年患者的死亡原因和模式。
这项前瞻性研究针对的是2005年1月至2007年6月期间入住伊洛林大学教学医院（UITH）的60岁及以上患者的死亡情况。研究期间所有送来时已死亡的患者被排除在外。获取的信息包括人口统计学数据、住院时间和诊断情况。死亡原因根据临床病程记录和诊断确定。
研究期间共发生1298例死亡，其中297例发生在60岁及以上人群，粗死亡率为22.8%。死亡时的平均年龄为68±9岁（范围为60 - 100岁）。其中男性占59%，女性占41%。女性死亡时的平均年龄为69.7±8.7岁，男性为68.1±9.8岁（P = 0.05）。血清化学指标的平均值为：钠137±8 mMol/l，钾3.6±1 mMol/l，尿素11±8 mMol/l，肌酐126±91 μmol/l。平均血常规浓度值为10.5±3 gm/dl，白细胞计数为12±2×10(9)/mm3。死亡时最常见的三种诊断是中风（19.8%）、败血症（16.5%）和下呼吸道疾病（8.1%）。传染病占所有诊断的38.2%。死亡时的集体平均住院时间（LOS）为6.8±8.6（范围为15分钟 - 60天）。近27.4%的死亡发生在24小时内，神经系统疾病的住院时间最短（4.6±6.3天），其次是内分泌疾病（6.8±8.4天）和呼吸系统疾病（8.4±5.6天）[P = 0.001]。
老年人的医院死亡率很高。中风和传染病是主要死因。应努力降低心血管疾病风险，并改善个人和社区卫生水平。
