PT  - JOURNAL ARTICLE
AU  - Basil Tumaini
AU  - Patricia Munseri
AU  - Kisali Pallangyo
TI  - Disease spectrum and outcomes among elderly patients in two tertiary hospitals in Dar es Salaam, Tanzania
AID  - 10.1101/554972
DP  - 2019 Jan 01
TA  - bioRxiv
PG  - 554972
4099  - http://biorxiv.org/content/early/2019/02/19/554972.short
4100  - http://biorxiv.org/content/early/2019/02/19/554972.full
AB  - Background There has been an increase in the number of individuals aged ≥60 years in Tanzania and in sub Saharan Africa in general due to improved survival. However there is scarcity of data on the disease burden, patterns and outcomes following admission in this population. We therefore describe the pattern of diagnoses, outcomes and factors associated with the outcomes among elderly patients admitted at Muhimbili National Hospital (MNH) and Jakaya Kikwete Cardiac Institute (JKCI) medical wards.Methodology We prospectively enrolled patients aged ≥60 years (elderly) admitted through MNH Emergency Medicine to the MNH medical wards and JKCI. ICD 10 was used to code for disease diagnosis at discharge or death. Modified Barthel index was used to assess for functional activity on admission and at discharge.Results We enrolled 336 elderly participants, who comprised 30.1% of all medical admissions. The mean age was 70.6 years; 50% were female and 263 (78.3%) had comorbidities with an average of 2 diagnoses per participant. The most common diagnoses were: hypertension (44.9%), stroke (31.5%), heart failure (18.5%), pneumonia (17.9%), diabetes mellitus (17.3%) and chronic kidney disease (16.4%). The median duration of hospital stay was 5 days and in-hospital mortality was 25.6%. Non-communicable diseases (NCDs) accounted for 65% of the deaths and 50% of the deaths occurred within 72 hours of hospitalization. A modified Barthel score of ≤20 on admission was associated with 15 times increased risk of death (p<0.001).Conclusion NCDs were the most common diagnoses and cause of death among patients aged ≥60 years admitted to the medical wards. In-hospital mortality was high and occurred within 72 hours of hospitalization. A modified Barthel score <20 on admission was associated with mortality.