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多哥住院老年患者三个月死亡率的预测因素。

Predictors of three-month mortality among hospitalized older adults in Togo.

机构信息

Département de Santé Publique, Université de Lomé, Faculté des Sciences de la Santé, Lomé, Togo.

Centre Africain de Recherche en Epidémiologie et en Santé Publique, Lomé, Togo.

出版信息

BMC Geriatr. 2020 Nov 26;20(1):507. doi: 10.1186/s12877-020-01907-y.

Abstract

BACKGROUND

Assessing hospital mortality and its predictors is important as some of these can be prevented through appropriate interventions. Few studies have reported hospital mortality data among older adults in sub-Saharan Africa. The objective of this study was to assess the mortality and associated factors among hospitalized older adults in Togo.

METHODS

We conducted a prospective cohort study from February 2018 to September 2019 among patients ≥50 years admitted in medical and surgical services of six hospitals in Togo. Data were recorded during hospitalization and through telephone follow-up survey within 90 days after admission. The main outcome was all-cause mortality at 3 months. Survival curves were estimated using the Kaplan-Meier method and Cox regression analyses were performed to assess predictors of mortality.

RESULTS

The median age of the 650 older adults included in the study period was 61 years, IQR: [55-70] and at least one comorbidity was identified in 59.7% of them. The all-cause mortality rate of 17.2% (95%CI: 14.4-20.4) and the majority of death (93.7%) occurred in hospital. Overall survival rate was 85.5 and 82.8% after 30 and 90 days of follow-up, respectively. Factors associated with 3-month mortality were the hospital level in the health pyramid, hospitalization service, length of stay, functional impairment, depression and malignant diseases.

CONCLUSION

Togolese health system needs to adjust its response to an aging population in order to provide the most effective care.

摘要

背景

评估医院死亡率及其预测因素很重要,因为其中一些可以通过适当的干预措施预防。很少有研究报告过撒哈拉以南非洲老年人的医院死亡率数据。本研究的目的是评估多哥住院老年人的死亡率及其相关因素。

方法

我们于 2018 年 2 月至 2019 年 9 月在多哥六家医院的内科和外科病房进行了一项前瞻性队列研究。研究期间记录了患者的住院数据,并通过电话随访调查在入院后 90 天内进行了随访。主要结局为 3 个月时的全因死亡率。使用 Kaplan-Meier 方法估计生存曲线,并进行 Cox 回归分析评估死亡率的预测因素。

结果

在研究期间,650 名年龄在 50 岁及以上的老年人的中位年龄为 61 岁,IQR:[55-70],其中 59.7%至少有一种合并症。全因死亡率为 17.2%(95%CI:14.4-20.4),大多数死亡(93.7%)发生在医院内。总体生存率分别为 30 天和 90 天随访后的 85.5%和 82.8%。与 3 个月死亡率相关的因素是卫生金字塔中的医院级别、住院科室、住院时间、功能障碍、抑郁和恶性疾病。

结论

多哥卫生系统需要调整其对人口老龄化的应对措施,以提供最有效的护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3109/7690011/62cd6377b3c7/12877_2020_1907_Fig1_HTML.jpg

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