Background: The state of health of the elderly varies considerably depending on their age. Older people are characterized by a more marked functional decline, increasing frailty and a high prevalence of chronic pathologies. Hence the more frequent use of emergency services. Objective: The aim of this study was to examine the comorbidities and conditions of elderly people admitted to emergency departments, and to compare the very elderly with younger seniors. Material and method: This was a retrospective descriptive and analytical study carried out over a six-month period in the medical emergency department of the Bouaké University Hospital, on patients aged 65 and over. Young senior patients (aged 65 to 74) were compared with so-called elderly senior patients (aged 75). Results: We included a population of 374 patients, representing a prevalence of 12.1%, divided into 56.9% young seniors and 43.1% elderly seniors. The mean age of the patients was 74.2 years, and the overall sex ratio of the sample was 1.21. With regard to comorbidities, a significant association was observed between advanced age and the development of heart disease. Infections were observed in 55.6% of patients, but no link was established between advanced age and the occurrence of infections. Pleuropulmonary infections were the most frequent (40.4%). On the other hand, for non-infectious pathologies, a link was noted between advancing age and cardiovascular pathologies. Stroke and decompensated heart disease were the most common pathologies in both young and elderly patients. No correlation was observed between the age of patients and the duration of their observation. The mortality rate was 26.4%, and a significant relationship was observed between advanced age and the occurrence of death (p = 0.04723), with a higher mortality rate in the elderly (31.6%) than in the young elderly (22.5%). Conclusion: Advancing age is associated with the onset and decompensation of cardiovascular pathologies. It is also associated with death. However, most comorbidities and acute emergencies remain similar in the two age groups.
References
[1]
Harman, D. (1991) The Aging Process: Major Risk Factor for Disease and Death. Proceedings of the National Academy of Sciences of the United States of America, 88, 5360-5363. https://doi.org/10.1073/pnas.88.12.5360
[2]
Siu, A.L. and the US Preventive Services Task Force (USPSTF). (2016) Screening for Depression in Adults: US Preventive Services Task Force Recommendation Statement. JAMA, 315, 380-387. https://doi.org/10.1001/jama.2015.18392
[3]
Fried, L.P., Ferrucci, L., Darer, J., Williamson, J.D. and Anderson, G. (2004) Untangling the Concepts of Disability, Frailty, and Comorbidity: Implications for Improved Targeting and Care. Journal of Gerontology: Medical Sciences, 59, 255-263. https://doi.org/10.1093/gerona/59.3.M255
[4]
Salvi, F., Morichi, V., Grilli, A., Giorgi, R., De Tommaso, G. and Dessì-Fulgheri, P. (2007) The Elderly in the Emergency Department: A Critical Review of Problems and Solutions. Internal and Emergency Medicine, 2, 292-301. https://doi.org/10.1007/s11739-007-0081-3
[5]
Drekonja, D.M., Arora, S., Johnson, J.R., et al. (2015) Urinary Tract Infections in Older Adults. Clinical Geriatrics, 31, 579-595.
[6]
Ministère du plan et du développement (2022) Recensement général de la population et de l’habitat 2021: Résultats globaux définitifs. Ministère du plan et du développement. https://www.caidp.ci/uploads/7113b93cc641ba78c591e9f79a4e729c.pdf
[7]
Dayoro, Z.A.K. (2022) Limites des solidarités publiques ressources mutualistes et couverture santé des seniors en Côte d’Ivoire. Revue africaine des sciences humaines et sociales, 3, 43-63.
[8]
World Health Organization (2021) Aging and Life-Course. World Health Organization. https://www.who.int
[9]
Aboderin, I. and Kinsella, K. (2017) The Impact of Global Ageing on Economic and Social Outcomes: Trends and Policy Implications. The Lancet, 390, 379-390.
[10]
Aboli, A. and Bakayoko, S. (2021) Les politiques de protection sociale et leur impact sur les personnes âgées en Afrique de l’Ouest: Le cas de la Côte d’Ivoire. African Journal of Social Protection, 13, 56-71.
[11]
World Health Organization (2022) Stratégie mondiale et plan d’action pour le vieillissement et la santé. World Health Organization. https://www.who.int/fr/salle-de-presse/fiches-d-information/detail/vieillissement-et-santé
[12]
Lemoine, A., et al. (2020) Fréquentation des urgences par les personnes âgées à l’hôpital universitaire: Étude rétrospective en France. Annales Françaises d’Anesthésie et de Réanimation, 39, 589-595.
[13]
Mendelsohn, D., et al. (2018) Emergency Department Utilization by the Elderly: A Review of U.S. Data. Journal of Aging & Health, 30, 759-773.
[14]
Buchner, A., et al. (2019) Emergency Care Utilization by Elderly Patients in Germany: A National Survey. European Journal of Emergency Medicine, 26, 273-279.
[15]
Ogunlesi, T.A., et al. (2020) Emergency Department Utilization among Elderly Patients in Lagos, Nigeria: A Retrospective Review. Nigerian Journal of Clinical Practice, 23, 525-532.
[16]
Buchanan, R., et al. (2019) Emergency Care Utilization by the Elderly in South Africa: A Study from Cape Town. African Journal of Emergency Medicine, 9, 63-68.
[17]
Diouf, A., et al. (2016) Fréquentation des urgences par les personnes âgées à Dakar, Sénégal. Revue d’Épidémiologie et de Santé Publique, 64, 133-139.
[18]
Aboderin, I.A. and Beard, J.R. (2015) Older People’s Health in Sub-Saharan Africa. The Lancet, 385, e9-e11. https://doi.org/10.1016/S0140-6736(14)61602-0
[19]
Jackson, C.F. and Wenger, N. K. (2011) Cardiovascular Disease in the Elderly. Revista Española de Cardiología (English Edition), 64, 697-712. https://doi.org/10.1016/j.rec.2011.05.003
[20]
Rehm, J., Shield, K.D., Gmel, G., et al. (2019) The Relationship between Different Dimensions of Alcohol Use and the Burden of Disease—An Update. Addiction, 114, 673-684.
[21]
Smith, S.E., Harris, P.G. and Cook, D.J. (2019) Impact of Direct Admissions on Emergency Department Waiting Times and Patient Outcomes. American Journal of Emergency Medicine, 37, 235-240.
[22]
Smith, A.J., Johnson, M. and Williams, R. (2020) Le rôle des structures d’urgence dans l’accueil des patients non référés: Un examen des pratiques et des défis. Journal of Emergency Medicine, 38, 113-120.
[23]
Tindle, H.A., Shiffman, S., Harkins, A.M., et al. (2018) Smoking Cessation among Older Adults: Findings from the US National Health Interview Survey. Tobacco Control, 27, 227-232.
[24]
Tetchi, Y., Abhé, C.M., Ouattara, A., et al. (2013) Profil des affections du sujet âgé africain aux urgences médicales du CHU de Cocody—Abidjan—(Côte d’Ivoire). Journal of European Emergency Medicine, 25, 147-151. https://doi.org/10.1016/j.jeurea.2013.07.002
Prabhudev, P., Ramamoorthi, K. and Acharya, R.V. (2023) A Clinical and Demographic Profile of Elderly (>65 Years) in the Medical Intensive Care Units of a Tertiary Care Center. Indian Journal of Critical Care Medicine, 27, 166-175. https://doi.org/10.5005/jp-journals-10071-24416
[27]
Stupka, J.E., Mortensen, E.M., Anzueto, A., et al. (2009) Community-Acquired Pneumonia in Elderly Patients. Aging Health, 5, 763-774. https://doi.org/10.2217/ahe.09.74
[28]
Mushtaq, S., Abro, M.T., Sualeah, M. and Uddin, M.R. (2022) Profile of Geriatric Patients Attending the Emergency Department of a Tertiary Care Hospital in Karachi: A Cross-sectional Study. Cureus, 14, e21874. https://doi.org/10.7759/cureus.21874
[29]
Singh, K. and Dey, S. (2018) Geriatric Morbidity Pattern in a Tertiary Care Center in the Hilly State of Sikkim. International Journal of Community Medicine and Public Health, 5, 1010-1013. https://doi.org/10.18203/2394-6040.ijcmph20180752
[30]
World Health Organization (2014) Malaria. https://www.who.int/fr/news-room/fact-sheets/detail/malaria
[31]
Alikor, C.A. and Eze, N.C. (2018) Non-Communicable Disease Admissions in Developing Country as Experienced from the Medical Ward of a Tertiary Centre in Nigeria. Central African Journal of Public Health, 4, 34-37. https://doi.org/10.11648/j.cajph.20180402.11
[32]
Gottwalles, Y., Dangelser, G., De Poli, F., et al. (2004) Acute STEMI in Old and Very Old Patients. The Real Life. Annales de Cardiologie et d’Angéiologie, 53, 305-313. https://doi.org/10.1016/j.ancard.2004.07.004
[33]
Yangatimbi, E., Grenaba, D.L., Kinima, J.P., et al. (2023) Profile and Prognostic Factors of Stroke in Age Subjects in Bangui. Neuroscience and Medicine, 14, 76-82. https://doi.org/10.4236/nm.2023.144006
[34]
N’goran, Y.N., Traore, F., Tano, M., et al. (2015) Aspects épidémiologiques des accidents vasculaires cérébraux (AVC) aux urgences de l’institut de cardiologie d’Abidjan (ICA). Pan African Medical Journal, 21, Article 160. https://doi.org/10.11604/pamj.2015.21.160.6852
[35]
Poddar, A., Selvam, S., Saroch, A., et al. (2023) Medical Emergencies and Comorbidities in the Elderly and Very Elderly Patients in North India. International Journal of Noncommunicable Diseases, 8, 75-83. https://doi.org/10.4103/jncd.jncd_15_23