Profile of geriatric presentations at the emergency department of a rural district hospital in South Africa

Benedict, Matthew; Adefuye, Anthonio Oladele

doi:10.11604/pamj.2020.36.245.22530

Cited by 4 publications

(4 citation statements)

References 32 publications

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“…The reasons for this may be due to deteriorating bone stock and an increase in the incidence of falls. [ 27 ] Similar finding was noted in Norway and UAE where bone fractures were the most common type of injuries observed; however, head injury was observed to be the most common form of injury reported in the study done in Abuja, Nigeria.…”

Section: Discussionsupporting

confidence: 76%

The Burden of Geriatric Trauma at the University College Hospital, Ibadan, Nigeria

Ogunrewo

Alonge

2021

Journal of West African College of Surgeons

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Background: Geriatric populations presently account for 9% of the world population and this is expected to increase. Injuries to the elderly accounted for 5.8 million accident and emergency visits in the USA as well as 4% of patients treated for traumatic injuries in Abuja, Nigeria. Traumatic injury is therefore a major cause of morbidity in the elderly as such the need for the study in our environment. Aims and Objectives: The aim(s) of this article is to review the incidence and types of traumatic injury among elderly population who presented at the University College Hospital, Ibadan, Nigeria and to determine the causes of traumatic injury involving the geriatric age group in our environment. Materials and Methods: A retrospective hospital-based study involving the records of geriatric patients who presented with traumatic injuries between January 2014 and June 2021 at the geriatric center and the accident and emergency department of the hospital. The record was retrieved from the Total Quality Management Unit of the hospital. Results: About 7.61% of the traumatic injury that presented at the accident and emergency department within the study period involved geriatric patients with a male-to-female ratio of 1:1.08, whereas 0.3% of the patients for inpatient care at the geriatric center had traumatic injury. Fall was the most common cause of traumatic injury observed and fracture the most common traumatic injury observed. Conclusion: Less than 10% of the patients with traumatic injury who presented at the University College Hospital, Ibadan, Nigeria are in the geriatric age group. Most of the traumatic injury involving geriatric patients in our environment is due to low energy falls, and fracture is the most common injury observed, with the femur being the most affected bone. Therefore, interventions directed at reducing the incidence of falls in our environment will hopefully help in reducing the incidence of traumatic injuries in the older population.

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Section: Discussionsupporting

confidence: 76%

The Burden of Geriatric Trauma at the University College Hospital, Ibadan, Nigeria

Ogunrewo

Alonge

2021

Journal of West African College of Surgeons

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“…According to the World Health Organization, this demographic phenomenon calls for preparedness in terms of dealing with chronic illnesses, provision of age friendly healthcare services as well as ensuring conducive environments. [7] Similar recommendations were made in a study in Free State Province, South Africa whose geriatric population accounted for almost 10 percent of the province's total population in 2017 [8].…”

Section: Introductionmentioning

confidence: 77%

Kenya’s ageing population: Current and future prospects

Mwaila¹,

Yousif²

2022

World J. Adv. Res. Rev.

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Introduction: By 2050, 1 in 6 people in the world will be aged over 65 while in 2019 seventeen countries globally reported that a fifth of their populations was geriatric. It is estimated that by 2030, Europe will be home to 24 percent of the world’s ageing population. Meantime, Japan has continued to take lead with the highest proportion of elderly persons. However, by 2050, Korea will surpass Japan. Geriatric population in developing countries is on a trajectory outpacing the developed countries. To confirm this trajectory, sub Saharan Africa is home to the youngest populations where Niger - with a median age of only 15.4 – leads among 17 countries globally. Study Objectives: This study aims to analyse Kenya’s population ageing with a view to presenting its growth since 1999 and projecting its future up to 2050. Study Data and Methods: The study uses data from the Kenya Population and Housing Censuses of 1999, 2009 and 2019. Multiple demographic analyses softwares are used, namely: US Census Bureau’s Population Analysis System (PAS); United Nations Population Division’s Software Package for Mortality Measurement (Mortpak) and Spectrum. Findings: Kenya’s population has grown by almost 20 million in the past two decades from 28.7 million in 1999 to 47.6 million in 2019. During the same period, the elderly population has grown from 3.3 percent to 3.94 percent. After stagnating between 1998 and 2008-09, Kenya’s fertility dropped rapidly from 4.6 births per woman in 2008-09 to 3.4 births per woman a decade later. The transition from youthful to aging population and therefore a shift in the population structure is expected as median age rises from 20 years in 2020 to 28 years by 2050 while total dependency ratio will drop from 75 percent to 48 percent during the same period. Rapid growth is projected in the aging population which is set to more than double from 1.87 million in 2019 to 4.77 million by 2050. Life expectancy will be higher among female geriatric population. By 2050, Kenya’s ageing population (60 and over) will be higher than that of children under five – 9.77 percent compared to 8.44 percent, respectively. Conclusion: Due to population momentum, Kenya’s population is set to grow by almost one million people annually between 2019 and 2050 while the elderly population is set to more than double during the same period. It is critical that considerations are made on expanding retirement age bands to allow the geriatric population to remain labour productive and contribute positively to economic growth. Meantime, the elderly population is important for enhancing social skills and cultural knowledge transfers at community level.

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“…8 The unique socio-political history of South Africa means that it encompasses both an ageing population, as experienced in HICs, and a burgeoning young population as encountered in the rest of Africa. 7,9 The current life expectancy in South Africa is sixty-five years, which is below that of HICs, but higher than other countries in Africa. 10 Over and above this, South Africa experiences a disproportionately high rate Background: Geriatric injuries comprise a significant burden in the developed world but much less are known in the developing world setting.…”

Section: Introductionmentioning

confidence: 97%

“…4,5 The management of geriatric trauma patients is made challenging by the presence of concurrent comorbidities, the use of polypharmacy, and decreased functional reserve. 6,7 Mortality also increases substantially with age, even adjusting for injury severity score when compared to younger adults, which reflects the vulnerability of this special patient population. 4,6 South Africa is a middle-income country (MIC) beset by huge discrepancies in wealth and access to healthcare.…”

Section: Introductionmentioning

confidence: 99%

The neglected epidemic of trauma from interpersonal violence against the elderly in South Africa

Lee¹,

Kong²,

Cheung³

et al. 2022

South African Journal of Surgery

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BACKGROUND: Geriatric injuries comprise a significant burden in the developed world but much less are known in the developing world setting. This study aims to review our experience of geriatric injuries with a focus on interpersonal violence (IPV) managed at a major trauma centre in South Africa. METHODS: This was a retrospective study on all patients who were aged > 65 years admitted to our trauma centre from January 2013 to December 2020, based in Pietermaritzburg, South Africa. RESULTS: Over the 8-year study period, 323 cases were included (62% male, mean age 72 years). Mechanism of injury: 80% blunt, 16% penetrating and 4% others. The median injury severity score (ISS) was 9. The median Charlson comorbidity index (CCI) for all 323 cases was 3. Diabetes (n = 53) was the most prevalent comorbidity which was followed by pulmonary disease (n = 23), cerebral vascular accidents (n = 16) and myocardial infarction (n = 15). Fifteen patients were on antiretroviral therapy (5%). Twenty-four per cent required surgical intervention. Eight per cent of cases experienced one or more complications. Twenty-five per cent (80/323) were related to IPV, 61% (49/80) of these were penetrating injuries and the remaining 31 cases were blunt injuries. Of the 49 cases of penetrating injuries, 33 were gunshot wounds (GSWs) and 16 were stab wounds (SWs) (1 GSW and 2 SWs were self-inflicted and were not included in IPV). Those cases that resulted from IPV were significantly more likely to require operative intervention, experience complications and longer lengths of hospital stay. Geriatric patients had poorer outcomes than non-geriatric patients and rural geriatric patients had worse outcomes than urban geriatric patients. CONCLUSION: Although the burden of geriatric trauma in South Africa appears to be relatively low, it is associated with significant morbidity and mortality. Trauma from interpersonal violence is especially common and is associated with significantly worse outcomes than that of non-interpersonal violence-related trauma. Elderly rural trauma victims have worse outcomes than their urban counterparts

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Profile of geriatric presentations at the emergency department of a rural district hospital in South Africa

Cited by 4 publications

References 32 publications

The Burden of Geriatric Trauma at the University College Hospital, Ibadan, Nigeria

The Burden of Geriatric Trauma at the University College Hospital, Ibadan, Nigeria

Kenya’s ageing population: Current and future prospects

The neglected epidemic of trauma from interpersonal violence against the elderly in South Africa

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