CORRELATE OF MULTIMORBIDITY AND MORTALITY AMONG IN-PATIENTS AT THE GERIATRIC CENTRE UCH, IBADAN (2013 – 2017)

Abstract

Background of study Multimorbidity among the elderly population has been reported to account for poor quality of life and an increased risk of mortality and hospital admissions in various studies. However, there’s a paucity of available literature on the effects of length of stay on multimorbidity and mortality in the elderly population in Nigeria. This study therefore examined the prevalence, patterns, and effects of length of stay on multimorbidity and mortality amidst other variables among the elderly. Methods A retrospective analysis of the inpatient data at the Chief Tony Anenih Geriatric Centre of the University College Hospital, Nigeria, from 2013-2017 was conducted. The outcome variables were multimorbidity and hospital outcome (dead or alive). Patients that were “discharged, transferred out and discharged against medical advice (DAMA) were categorised as “alive” while patients that died during the period were categorised as “dead”. The primary exposure was length of hospital stay while the covariates were age, sex, family type, religion, tribe, occupation, marital status, alcohol consumption, body mass index and hospital investigations. Poisson regression analysis was used to model the relationship between multimorbidity and length of stay amidst other covariates while Cox regression was used to determine the association between Multimorbidity and Mortality using length of stay as time (T) amidst other covariates listed above. Descriptive statistics, IRR/HR and 95% CI were presented. Results A total of 1091 patients’ records were reviewed. The mean age was 73.6±8.63 years. The prevalence of multimorbidity was 68%; 46.5% of multimorbid patients had two comorbidities while 5.9% had more than four comorbidities. The poisson regression showed that patients age 85 years and above had 26% increased risk of multimorbidity compared to patients within the age group 60-64 years (IRR=1.26, 95%CI= 1.07,1.47). There was an increase in risk of multimorbidity with length of stay. Patients that stayed for more the ten days on bed had a greater risk (35.2%) of multimorbidity compared to patients that spent less than three days (IRR = 1.35, 95% CI: 1.02, 1.80). Results from the cox regression shows that multimorbidity also affect mortality, as morbid patients are 15.7% more likely to die during admission compared to non-morbid patients (HR=1.16, 95% CI: 1.01-1.33) Conclusion Our findings showed a notable high prevalence of multimorbidity among elderly patients at the Chief Tony Anenih. Geriatric Centre. Multimorbidity was associated with mortality, and was influenced by length of hospital stay. This calls for holistic management of the elderly, with a focus on improving the quality of care by promoting home care treatment.