Simakoloyi Natalie, Erasmus Elaine, van Hoving Daniël Jacobus
Division of Emergency Medicine, Stellenbosch University, Cape Town, South Africa.
Afr J Emerg Med. 2022 Mar;12(1):39-43. doi: 10.1016/j.afjem.2021.11.005. Epub 2022 Jan 12.
The world's population is aging and this trend is also seen in South Africa. This increase will invariably affect acute care services. The geriatric population attending emergency centres have not been described in the South African setting. The objective was to describe the characteristics of geriatric patients presenting to the resuscitation unit of a district-level hospital in Cape Town.
All patients (≥65 years) managed within the resuscitation unit of Khayelitsha Hospital over an 8-month period (01 January-30 August 2018) were retrospective analysed. Data were collected from the Khayelitsha Hospital Emergency Centre database and by means of a retrospective chart review. Summary statistics are presented of all variables.
A total of 225 patients were analysed. The median age was 71.1 years, 148 (65.8%) were female and all were residing in their family home. The majority ( = 162, 72%) presented outside office hours, 124 (55.1%) arrived by ambulance, and 94 (41.8%) had presented to the emergency centre within the previous year. Only half the patients ( = 114, 50.7%) were triaged as very urgent or higher. Most patients ( = 169, 75.1%) were admitted by in-hospital services and the in-hospital mortality was 21.8% ( = 49). Diseases related to the circulatory system ( = 54, 24.0%) were the most frequent primary diagnosis and acute kidney injury were the most frequent secondary diagnosis ( = 101, 44.9%). The most common comorbidities were hypertension ( = 176, 78.2%) and diabetes ( = 110, 48.9%), and 99 (44%) had three or more comorbidities. Polypharmacy (≥5 medications) occurred in 100 (44.4%) patients with 114 (50.7%) using medications from three or more different classes. The prevalence of hypernatremia was 2.6% and for hyponatremia 54.4%.
Geriatric patients managed within the resuscitation unit of a district-level hospital had a high return rate, multiple comorbidities and a high prevalence of polypharmacy and hyponatraemia.
世界人口正在老龄化，南非也呈现出这一趋势。这种增长必然会影响急性护理服务。在南非的背景下，尚未对前往急诊中心的老年人群进行描述。目的是描述在开普敦一家区级医院的复苏病房就诊的老年患者的特征。
对2018年1月1日至8月30日这8个月期间在Khayelitsha医院复苏病房接受治疗的所有患者（≥65岁）进行回顾性分析。数据从Khayelitsha医院急诊中心数据库收集，并通过回顾性病历审查获得。对所有变量进行汇总统计。
共分析了225例患者。中位年龄为71.1岁，148例（65.8%）为女性，所有患者均居住在自己家中。大多数患者（n = 162，72%）在办公时间以外就诊，124例（55.1%）乘坐救护车到达，94例（41.8%）在过去一年中曾到过急诊中心。只有一半的患者（n = 114，50.7%）被分诊为非常紧急或更紧急。大多数患者（n = 169，75.1%）由医院服务部门收治，住院死亡率为21.8%（n = 49）。循环系统相关疾病（n = 54，24.0%）是最常见的主要诊断，急性肾损伤是最常见的次要诊断（n = 101，44.9%）。最常见的合并症是高血压（n = 176，78.2%）和糖尿病（n = 110，48.9%），99例（44%）有三种或更多合并症。100例（44.4%）患者存在多重用药（≥5种药物），其中114例（50.7%）使用来自三种或更多不同类别的药物。高钠血症的患病率为2.6%，低钠血症的患病率为54.4%。
在区级医院复苏病房接受治疗的老年患者复诊率高、合并多种疾病、多重用药和低钠血症患病率高。
