Profile and causes of mortality among elderly patients seen in a tertiary care hospital in Nigeria

Background: Old age is one of the factors associated with increased risk of dying when admitted to hospital. Therefore, aim of this study was to examine causes and pattern of death among elderly patients managed in a tertiary care hospital in Nigeria with scanty mortality records. Materials and Methods: This prospective study was on deaths that occurred in patients 60 years and above admitted to University of Ilorin Teaching Hospital (UITH), Ilorin, between January 2005 and June 2007. Excluded were all brought-in-dead during the study period. Information obtained included demographic data, duration on admission, and diagnosis. Causes of death were determined from clinical progress notes and diagnosis. Results: A total of 1298 deaths occurred during the study period, of which 297 occurred in persons 60 years and above with crude death rate of 22.8%. The mean age at death was 68 +/- 9 years (ranged 60-100 years). This consisted of 59% males and 41% females. Mean age at death for females was 69.7 +/- 8.7 years and for males 68.1 +/- 9.8 years (P= 0.05). Mean values of serum chemistry were sodium 137 +/- 8 mMol/l, potassium 3.6 +/- 1 mMol/l, urea 11 +/- 8 mMol/l, and creatinine 126 +/- 91 mumol/l. The value of mean haemogram concentration was 10.5 +/- 3 gm/dl and white cell count was 12 +/- 2 x 109/mm(3). The three most common diagnoses at deaths were stroke (19.8%), sepsis (16.5%), and lower respiratory tract disease (8.1%). Infectious diseases accounted for 38.2% of all diagnoses. Collective mean length of hospital stay (LOS) at death was 6.8 +/- 8.6 (ranged 15 minutes-60 days). Close to 27.4% of the deaths occurred within 24 hours and neurological disorder had shortest hospital stay (4.6 +/- 6.3 days), followed by endocrine disorders (6.8 +/- 8.4 days) and respiratory diseases (8.4 +/- 5.6 days) [P= 0.001]. Conclusion: Hospital mortality is high amongst older people. Stroke and infectious diseases are leading causes of death. Efforts should be geared toward reducing risk for cardiovascular diseases and improvement on level of personal and community hygiene.