Assessment of clinical and demographic profile of elderly patients admitted in emergency department of Government Medical College Jammu

Abstract

Background: Ageing is characterized by a gradual decline in organ functional reserves which reduces the ability to maintain homeostasis. The present study was conducted to study the clinical and demographic profile of elderly patients admitted in emergency department of Government Medical College Jammu. Materials & Methods: A total of 1000 patients were recruited during the study period and were subjected to lipid profile, serum calcium, thyroid stimulating hormone level and other necessary investigations. Results: The mean age of the 1000 study participants was 72.80±7.04 years. Male and female comprised of 45.6% and 55.4% of the participants respectively. 47.5% of participants presented to ED within 24 hours, 42.5% between 1-5 days, 9.5% between 6-10 days, and only 0.5 % after 10 days from the onset of initial symptoms. Themost common symptom was shortness of breath (37%) followed by fever (23.5%), giddiness (18%), nausea/vomiting (17.5%), generalised malaise (13.5%), focal neurological deficits (12.8%), others (12.5%),history of chest pain (10.7%)and altered sensorium (10.5%). The least common symptom was abdominal pain (7.5%). The most common cause was respiratory (19.5%) followed by infectious (17.6%), cardiovascular (17.4%), neurological (14.4%), and gastrointestinal (13.5%), followed by metabolic (9.8%), and then renal (6.5%). The least common cause was neoplasm (1.3%). The most common comorbidity found in the current study was endocrinological and metabolic in the form of hypertension (51%), followed by type II diabetes mellitus (38.5%). Hypothyroidism was found in 9.5% of participants. Among the respiratory comorbid conditions, chronic obstructive pulmonary disease and bronchial asthma were reported among 19% and 3.5% of the participants respectively. Amongst the cardiovascular conditions, coronary artery disease was found amongst 18% of participants, whereas Rheumatic Heart Disease and Dilated Cardiomyopathy were present in 2.5% each respectively. Chronic kidney disease was found in 7% of the participants, while 12.5% of participants had a history of old CVA. Chronic Liver Disease constituted 6.8 %, Psychiatric Disorder was present amongst 3% of study participants, Malignancy constituted 2.5%. 83% of patients required hospital admission (ICU or Ward), 9.9% were managed on an outpatient basis on oral medicines, and 7.1 % suffered death. Conclusion: 75% of the elderly reside in rural areas, and it is essential that geriatric health care services be made a part of the primary health care services. Specialized training of doctors in geriatric medicine needs to improve and increase on a large scale to meet the health demands of the second most populous country in the world.

Key words: elderly, Bronchial Asthma, Malignancy