African Journal of Emergency Medicine (Mar 2022)
The characteristics of geriatric patients managed within the resuscitation unit of a district-level emergency centre in Cape Town
Abstract
Introduction: The world's population is aging and this trend is also seen in South Africa. This increase will invariably affect acute care services. The geriatric population attending emergency centres have not been described in the South African setting. The objective was to describe the characteristics of geriatric patients presenting to the resuscitation unit of a district-level hospital in Cape Town. Methods: All patients (≥65 years) managed within the resuscitation unit of Khayelitsha Hospital over an 8-month period (01 January–30 August 2018) were retrospective analysed. Data were collected from the Khayelitsha Hospital Emergency Centre database and by means of a retrospective chart review. Summary statistics are presented of all variables. Results: A total of 225 patients were analysed. The median age was 71.1 years, 148 (65.8%) were female and all were residing in their family home. The majority (n = 162, 72%) presented outside office hours, 124 (55.1%) arrived by ambulance, and 94 (41.8%) had presented to the emergency centre within the previous year. Only half the patients (n = 114, 50.7%) were triaged as very urgent or higher. Most patients (n = 169, 75.1%) were admitted by in-hospital services and the in-hospital mortality was 21.8% (n = 49). Diseases related to the circulatory system (n = 54, 24.0%) were the most frequent primary diagnosis and acute kidney injury were the most frequent secondary diagnosis (n = 101, 44.9%). The most common comorbidities were hypertension (n = 176, 78.2%) and diabetes (n = 110, 48.9%), and 99 (44%) had three or more comorbidities. Polypharmacy (≥5 medications) occurred in 100 (44.4%) patients with 114 (50.7%) using medications from three or more different classes. The prevalence of hypernatremia was 2.6% and for hyponatremia 54.4%. Conclusion: Geriatric patients managed within the resuscitation unit of a district-level hospital had a high return rate, multiple comorbidities and a high prevalence of polypharmacy and hyponatraemia.
