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乌干达西南部一家地区转诊医院中老年住院患者的临床状况及其治疗结果

Clinical Conditions of Hospitalized Older Adult Patients and Their Outcomes in a Regional Referral Hospital in Southwestern Uganda.

作者信息

Orikiriza Patrick, Rukundo Godfrey Z, Kayanja Adrian, Bazira Joel

机构信息

Department of Microbiology, Mbarara University of Science and Technology, Mbarara, Uganda.

Division of Basic Medical Sciences, University of Global Health Equity, Kigali, Rwanda.

出版信息

J Aging Res. 2020 Jun 29;2020:6830495. doi: 10.1155/2020/6830495. eCollection 2020.

Abstract

BACKGROUND

Recent advances in medicine have caused positive impact on the life expectancy of most countries, resulting in increased older adult population. Aging comes with a number of health challenges. This study investigated health conditions of older adults at admission and clinical outcomes in a regional referral hospital in southwestern Uganda.

METHODS

A retrospective study reviewed clinical data of older adult patients admitted between January 2016 and December 2017. Demographic data, cause of admission, length, and outcomes of hospitalization are described.

RESULTS

Up to 813 patient files were reviewed. The patients had been hospitalized to emergency, 371 (45.6%); medical, 355 (43.7%); surgical, 84 (10.3%); psychiatry, 2 (0.3%); and obstetrics and gynecology, 1 (0.1%) wards. The majority, 427 (52.5%), of the patients were females. Cancer was the most common reason for hospitalization, 130/889 (14.6%), followed by stroke, 94/889 (10.6%); heart failure, 76/889 (8.6%); chronic obstructive pulmonary disease, 56/889 (6.3%); pneumonia, 47/889 (5.3%); and head injury, 45/889 (5.1%), whilst 560 (68.9%) of the hospitalized patients were discharged, 197 (24.2%) died, 18 (2.2%) were referred for advanced care, and 38 (4.7%) escaped from the facility. The emergency ward had the highest deaths, 101 (51.3%), then medical, 56 (28.4%), and surgical, 39 (19.8%), wards. Mortality of those who died was admitted with stroke, 30 (15.2%), cancer, 21 (10.7%), head injury, 16 (8.1%), heart failure, 14 (7.1%), sepsis, 14 (7.1%), and renal disease, 12 (6.1%). On average, patients were admitted for 5 days (IQR: 3-8).

CONCLUSIONS

The high proportion of mortality in this group is worrying and requires further investigations.

摘要

背景

医学上的最新进展对大多数国家的预期寿命产生了积极影响,导致老年人口增加。衰老伴随着许多健康挑战。本研究调查了乌干达西南部一家地区转诊医院老年患者入院时的健康状况及临床结局。

方法

一项回顾性研究对2016年1月至2017年12月期间入院的老年患者的临床数据进行了审查。描述了人口统计学数据、入院原因、住院时长及结局。

结果

共审查了813份患者档案。患者被收治到急诊病房的有371例(45.6%);内科病房355例(43.7%);外科病房84例(10.3%);精神科病房2例(0.3%);妇产科病房1例(0.1%)。大多数患者为女性,共427例(52.5%)。癌症是最常见的住院原因,130/889(14.6%),其次是中风,94/889(10.6%);心力衰竭,76/889(8.6%);慢性阻塞性肺疾病,56/889(6.3%);肺炎,47/889(5.3%);头部损伤,45/889(5.1%)。住院患者中560例(68.9%)出院,197例(24.2%)死亡,18例(2.2%)被转诊接受高级护理,38例(4.7%)从医院逃脱。急诊病房的死亡人数最多,为101例(51.3%),其次是内科病房56例(28.4%),外科病房39例(19.8%)。死亡患者中因中风入院的有30例(15.2%),癌症21例(10.7%),头部损伤16例(8.1%),心力衰竭14例(7.1%),败血症14例(7.1%),肾病12例(6.1%)。患者平均住院5天(四分位间距:3 - 8天)。

结论

该组患者的高死亡率令人担忧,需要进一步调查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8a6e/7341388/9233454e323f/JAR2020-6830495.001.jpg

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