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ABSTRACT
Introduction. Older people hospitalization may lead to adverse outcomes and increased mortality due to the combination of acute illness and geriatric syndromes. We aimed to determine in-hospital mortality and its correlates among patients admitted in an acute geriatric unit in Cameroon. Methods. Records of all patients aged 65 and over consecutively admitted in the Acute Geriatric Unit of the Yaoundé Central Hospital from January 2019 to December 2021 were reviewed. Sociodemographic, clinical and biological data were collected. Geriatric syndromes included activities of daily living disability, delirium, urinary incontinence, falls, pressure ulcers and polypharmacy. Data were analyzed using SPSS 23.0 and a logistic regression was performed to identify factors associated with mortality. A p-value less than 0.05 was statistically significant. Results.  Three hundred and one patients were admitted during the study period of whom 60.5% (n=182) were female. The mean age was 79.4±8.4 years, with 68% of patients being 75 and over. The majority of patients was admitted from the emergency department (74%, n=223). The overall mortality rate was 26%. Delirium (OR 5.6 95% CI 2.7-11.5, p<0.001), pressure ulcers (OR 6.2 95% CI 1.3-30.5, p=0.025) and sepsis (OR 5.9 95% CI 2.7-12.6, p<0.001) were independently associated with in-hospital mortality. Conclusion. In-hospital mortality rate is high in acute geriatric care unit especially in patients presenting with delirium, pressure ulcers or sepsis. Early detection and management of older patients with those conditions can help improve survival.  
 
RÉSUMÉ
Introduction. Les personnes âgées hospitalisées ont un risque élevé de décès en rapport avec les effets combinés des affections aiguës et des syndromes gériatriques. L’objectif  de l’étude était de déterminer le taux de mortalité hospitalière et ses déterminants. Matériel et méthodes. Nous avons mené une étude rétrospective sur les dossiers des patients de 65 ans et plus admis dans le service de gériatrie de l’Hôpital Central de Yaoundé entre janvier 2019 et décembre 2021. En plus des caractéristiques sociodémographiques, cliniques et biologiques nous avons décrit les syndromes gériatriques tels que la dépendance, la confusion, les chutes, l’incontinence urinaire, les escarres et la polypharmacie. Les données ont été analysées avec SPSS 23.0 et une analyse multivariée a été effectuée avec un seuil de significativité statistique p<0,05. Résultats. Nous avons inclus 301 patients dont une majorité de femmes (60,5% ; n=182). La moyenne d’âge était de 79,4±8,4 ans avec près de 68% des patients qui avaient plus de 75 ans. La majorité des patients étaient transférés des urgences médicales (74% ; n=223) et le taux de mortalité était de 26%. Les facteurs indépendamment associés à la mortalité étaient la confusion (OR 5,6 95% CI 2,7-11,5 ; p<0,001), les escarres (OR 6,2 95% CI 1,3-30,5 ; p=0,025) et le sepsis (OR 5,9 95% CI 2,7-12,6 ; p<0,001). Conclusion.  La mortalité des patients âgés hospitalisés en gériatrie est élevée en particulier en cas de confusion mentale, sepsis et en présence d’escarres. L’identification précoce des patients à risque permettra d’améliorer la survie.

Keywords

mortality, older patients, geriatric syndromes, Cameroon

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Marie-Josiane Ntsama Essomba, Régine Mylène Mballa Mba, Marylin Zingui Ottou, & Madeleine Ngandeu Singwe. (2023). In-Hospital Mortality and Associated Factors in Acute Geriatric Care in Cameroon: A Retrospective Study. HEALTH SCIENCES AND DISEASE, 24(2 Suppl 1). https://doi.org/10.5281/hsd.v24i2 Suppl 1.4268
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