Patterns of surgical admissions among geriatric patients admitted to Bugando Medical Centre, Mwanza, Tanzania

Abstract

Background: Surgery in geriatric patients constitutes a major but neglected public health problem. It hence poses a great challenge to surgeons and general practitioners practising in a resource-limited setting. Geriatric patients are increasingly hospitalized in surgical wards in Tanzania and little information is currently available on this group of patients. This study aimed to determine the pattern of diseases and clinical outcomes among geriatric surgical patients at Bugando Medical Centre and to identify the predictors of outcomes among these patients in our local setting. Methods and Patients: It was a cross-sectional study of geriatric surgical patients admitted to BMC from June 2017 to April 2018. Results: Out of 304 geriatric surgical patients enrolled, males outnumbered females by a male to female ratio of 3.1: 1. The majority of patients were in the 7th decade of life.  Associated medical comorbidities were reported in 107 (35.2%) patients. Urology speciality had the highest number of geriatric patients (101; 60.2%) admitted to BMC followed by general surgery in 70 (23.0%) patients. Gynaecology and Neurosurgery had the least number of geriatric patients with 4(1.3%) and 1(0.3%) patients admitted respectively. The majority of geriatric surgical patients, 286(94.1%) were treated surgically. A total of 168 patients (58.7%) developed postoperative complications. The mortality rate was 15.2% and it was significantly associated with loa ng duration of illness, high American Society of Anesthesiologist class, operation under gene anaesthesia and prolonged duration of the operation. Conclusion: This study demonstrated that surgeries among geriatric patients are commonly performed at BMC and are associated with unacceptably high morbidity and mortality. Factors responsible for the high morbidity and mortality in our geriatric surgical patients should be addressed to improve the surgical outcomes in this group of patients.