Stroke is the biggest killer of SA’s elderly, but it needn’t be
Researchers find that survival rates are boosted by having dedicated beds for older patients
Strokes, heart failure and heart attacks are the most common causes of death among SA’s elderly, and most victims of these conditions die within 24 hours of hospital admission.
A study by researchers from the University of Cape Town and University College Hospital in Nigeria also reveals that even though the most common cause of hospital admissions among the elderly was heart attack, the biggest killer is stroke.
Only one in 14 elderly patients admitted to Groote Schuur Hospital in Cape Town between 2010 and 2013 had suffered a stroke, but the condition accounted for one in seven deaths.
Heart failure, which affected 7.4% of elderly patients, was responsible for about 8% of deaths. Infection or white blood cell count and high blood urea – a symptom of kidney failure - was also associated with rapid death after hospital admission.
Researchers said the proportion of deaths was similar to in-hospital deaths among elderly patients in medical wards in Africa and South America.
Writing in the SA Medical Journal, lead researcher Dr Lawrence Adebusoye said dedicated beds for ageing patients seemed to improve their survival rates.
He said the reduction in mortality noted over the four years of the study may be attributable to an increase in beds for the elderly at Groote Schuur. At the same time, medical teams were reorganised, resulting in improved efficiency.
“The medical teams were each provided with a dedicated ward in the last year of study, whereas in previous years medical wards were shared as an open space by the different medical teams,” said Adebusoye.
“Having space dedicated to each team may have impacted positively on care of older patients in the medical wards by providing focused patient care and improved handovers.”
SA has the second-largest proportion of elderly citizens in Africa, after Mauritius, and the number of over-60s is expected to increase from 2.7 million in 1985 to 5.23 million by 2025.
Globally, hospital admission and mortality rates among older people are continuously increasing owing to physiological factors associated with ageing.
Adebusoye said the high proportion of elderly emergency patients at hospitals showed there was a need for “effective and more frequent outpatient appointments”.
“This extra effort will facilitate early diagnosis and management of acute exacerbations and complications of morbidities,” he said.
“The association of mortality with laboratory biomarkers also shows the need for adequate investigation and management of the morbidities with which these biomarkers are associated.”