Characteristics and outcomes of elderly patients admitted for medical reasons in Rwanda University Teaching Hospitals: current situation at CHUK and CHUB.

Abstract

Introduction

Elderly patients are becoming an important demographic group in the healthcare system in Rwanda. This study aimed to show the characteristics of admission and outcomes of elderly patients admitted for medical reasons in two main public tertiary hospitals.

Methods: This was a three-month period prospective descriptive cross-sectional analytical study done on elderly patients aged ≥ 60 years at University Teaching Hospitals of Kigali and Butare. The non-probability sampling method, convenience sampling type was used for study enrollment. Socio-demographic variables, initial clinical presentation, diagnoses at discharge and outcomes were recorded. Katz ADL, O3DY and MNA scale were used to assess respectively dependency, cognitive dysfunction and nutritional status. We used ICD 10 to code for disease diagnosis at discharge or death. Data were analyzed using Stata/MP 16.0 version software.

Results: Elderly patients comprised 34.5% of all admissions and 190 of them were enrolled in this study. The mean age was 72.8 (± 8.8) years and male to female ratio was of 1:1.47. 67% presented having prior medical comorbidities dominated by hypertension at 58.1%. The commonest complaints at presentation were shortness of breath (30.5%), altered mental status (20%) and non-specific symptoms (12.6%). 47.3% of the sick elderly people were found to be malnourished at their admission. The most common diagnoses were: malignant neoplasm (21.5%), pneumonia (18.4%), stroke (11.5%), hypertension (10.0%), diabetes mellitus (7.8%), acute kidney injury (7.3%), heart failure (6.8%) and chronic kidney disease (5.7%). The median duration of hospital stay was 11 days and in-hospital mortality was 23.2%. Malnutrition, malignant neoplasms and chronic kidney disease were associated with the worse outcome.

Conclusion: Non communicable diseases were the most common cause of admission and death among elderly patients admitted for medical reasons. Malnutrition was found to be high and also associated with worse outcome in hospitalized elderly patients.