INJURY PATTERN IN THE ELDERLY: IMPLICATIONS FOR SAFETY
Morbidity and mortality among the elderly population is a preventable public health problem globally as well as in developing countries like Nigeria. This study aimed to document the patterns and outcomes of injuries among elderly patients who presented to the emergency department (ED) of the University College Hospital, Ibadan, Nigeria.
METHODS:
This was a hospital-based cross-sectional survey in which data on elderly injuries between January 2011 & December 2012 was retrieved from the ED electronic register. Injury severity was measured using the Injury Severity Score (ISS) and the Glasgow Coma Scale (GCS). Multivariate analysis using Logistic Regression analysis at p=0.05 were done on SPSS version 15.
RESULTS:
There were 407 elderly trauma patients comprising 236 males and 171 females with mean age 73.63±7.52. Road traffic accidents, RTAs (50.6%) and falls (38.6%) were the commonest injury types. Head and neck injuries were most common (38.8%) followed by lower limb (32.7%) and polytrauma (30.7%). Almost half (46.9%) were discharged directly from the ED, 30.7% were admitted into other wards and there were 35 deaths giving an all-cause mortality rate of 86/1000. High specific mortality rate (SMR) occurred among those with polytrauma (216/1000), head & neck injuries (158/1000) and RTAs (140/1000) while the lowest was from falls (19/1000).The mean ISS and GCS scores were 26.0±11.1 and 11.1±4.1 respectively. Patients with high ISS >26.0 and low GCS <11.1 scores were more likely to die following injury (OR=4.11, 95%CI 1.17-14.41 and OR=3.90, 95%CI 1.26-12.04 respectively).
CONCLUSIONS:
The safety of the environment contributes significantly to the rates of morbidity and mortality due to injuries among the elderly population. Reducing this burden will involve ensuring age-friendly environments in the homes and on the roads.