Mortality pattern of elderly patients at a tertiary care hospital: A study from Sub-Himalayan region, Uttarakhand, India

J Family Med Prim Care. 2019 Feb;8(2):426-431. doi: 10.4103/jfmpc.jfmpc_416_18.

Abstract

Background: Currently, in developing countries like India, there is a paradigm shift in the mortality patterns of elderly from communicable to noncommunicable diseases.

Objective: This study is aimed at providing an insight on mortality patterns of elderly patients within a 2-year period in a tertiary hospital, All India Institute of Medical Sciences (AIIMS), Rishikesh, India.

Materials and methods: This study is a retrospective review of mortality patterns of elderly patients from March 2016 to March 2018 occurring in the Department of General Medicine, in AIIMS, Rishikesh, India. Information derived from the Medical Records Department of AIIMS Rishikesh include age, sex, clinical history, diagnosis, duration, and cause of death.

Results: During this period, a total of 1101 elderly (≥60 years) admissions were done in the Department of General Medicine, AIIMS Rishikesh. A total of 66 patients had expired during their hospital stay. Among this, 35 and 31 cases were elderly male and female patients, respectively, and therefore the ratio of male to female was 1.1:1.0. The peak age group was 60-64 years accounting for 23 patients (34.8%). The age range of patients was 60-94 years, while the modal and mean ages were 65 and 69 years, respectively, with 8.1 standard deviation. The most commonly encountered cause of mortality was cerebrovascular accident constituting 19 (28.8%) cases. The second majority of mortality cases were hypertensive disorders constituting 13 (19.7%) cases, and the third majority were septicemia and pneumonia accounting for 12 (18.2%) and 12 (18.2%) cases, respectively. Others include diabetes mellitus [metabolic disorder; 10 (15.2%) cases], acute renal failure [10 (15.2%) cases], ischemic heart disease or coronary artery disease [6 (9.1%) cases], while malignancies, tuberculosis, hepatitis, chronic liver disease, and chronic obstructive pulmonary disease consisted of five cases (7.6%) each.

Conclusion: Noncommunicable diseases particularly cerebrovascular diseases and hypertensive disorders were the most commonly encountered cause of elderly mortality in this region of North India, that is, the state of Uttarakhand. Notwithstanding a large percentage of mortality patterns also results from communicable diseases with septicemia and pneumonia as the third leading cause of mortality.

Keywords: Cerebrovascular accident; hypertensive disorders; mortality; septicemia.