Chapters authored
Inhospital Outcome of Elderly Patients in an Intensive Care Unit in a Sub-Saharan Hospital
People living more and more longer and elderly is growing and that requires change in health system including geriatric care to be innovative. The aim of this study was to analyze causes and prognosis of older patients admitted in an intensive care unit (ICU) in Sub-Sahara area. A retrospective study over 5 years of patients aged 65 years and above admitted in ICU of Yalgado Ouedraogo was carried out. Of the 2116 patients admitted in ICU, 237 (11.2%) were older. The mean age was 71.7 ± 6.1 years. Males were predominant (sex ratio = 2.4). Medical history was present in 80.6%. The Charlson mean score was 4.8 ± 1.8. Patients with coma represented 42%. Ambulatory Simplified Acute Physiologic Score (ASAPS) up to 8 was recorded in 49%. Medical diseases (60%) like nervous system (37.9%) were reported. Stroke and general surgery were the main affection. Globally treatment was based on fluid management and oxygen supply. During ICU stay, complications occurred in 37.5% like acute respiratory distress syndrome (ARDS) in 10.5%. The mean length of stay was 5.3 ± 7.4 days. The elderly mortality was 73%; those 90% died within 7 days. In multivariate analysis, shock (odds ratio: OR = 2.2, p = 0.002), severe brain trauma (OR = 9.6, p = 0.002), coma (OR 5.8 p < 0.003), surgical condition (OR = 4.2, p = 0.003), ASAPS ≥ 8 (OR = 4.3, p = 0.001), complication occurring (OR = 5.2, p = 0.001), and stroke (OR = 3.7, p = 0.001) were independent risk factors of death. Elderly patients are frequently admitted in ICU with high mortality.
Part of the book: Strategies to Reduce Hospital Mortality in Lower and Middle Income Countries (LMICs) and Resource-Limited Settings