Volume : 5, Issue : 4, April - 2016

To study morbidity pattern among Geriatric patients attending Inpatient Department of a Tertiary care hospital of North India

Dr. Shahnawaz Hamid, Dr. Farooq Jan, Dr. Haroon Rashid

Abstract :

<p>&lt;p&gt;&amp;lt;p&amp;gt;&amp;amp;nbsp;INTRODUCTION:Geraitrics is the anch of medicine dealing with the diseases, disabilities and care of aged persons AIM: as people age the mind and body become more vulnerable. This means that people become more sensitive to things like stress, injuries, illnesses, and medication side-effects so the present study is undertaken to see the morbidity pattern among geriatrics attending a tertiary care institute.MATERIAL AND METHODOLOGY: The study was carried out in Inpatient departments SKIMS Srinagar. The study was done from Ist January 2013 to 31st December 2013 ( i.e for a period of one year) .It was a prospective type of study undertaken on elderly people as defined in study population .It was a Questionnaire based study. Questions were asked as per Annexures by an investigator to each selected case and answers were filled by investigator at the same time. Cases were selected by Systematic Random sampling method by picking every 5th patient of the target population (&amp;amp;gt; 60 years of age as defined in subsequent paragraph) after checking the admission files in the respective wards. The study was carried out every day and as per turn every ward was used for study (excluding those patients who were admitted and discharged in the Emergency Medicine itself).A total of 421 cases selected through systematic random sampling were studied. The questionnaire was developed and validated by a pilot study. The questionnaire had questions pertaining to morbidity pattern of elderly . The questionnaire includes 9 questions related to morbidity pattern. The questions regarding morbidity pattern were reproduced from Stanford Arthritis center disability and discomfort scales 1981 which were modified as per the need of the study. Morbidity in elderly was assessed by their ability to dress and groom, arise, walk, grip and other day to day activities performed by elderly. The responses were graded on likert scale.The study population were elderly (Geriatric) group of people with age greater than or equal to 60 years (&amp;amp;gt; 60years) as per their medical record. Inclusion Criteria: All those selected elderly people who agree to participate in the study. Exclusion Criteria: a) All those patients who does not agree to participate in the study. b) Those patients who were comatose or on ventilator c) Those who were admitted and discharged in emergency medicine itself. The responses obtained on the questionnaires were converted into data over a Microsoft Excel sheet. Each response was given a numerical code. The Questions having graded responses were marked on likert scale and were given numerical codes from 1-3, 1-4 or 1-5. All categorical variables were compared using Pearson&amp;amp;rsquo;s Chi Square test and P value &amp;amp;lt; 0.05 were considered to be statistically significant. Data was analyzed using SPSS software version 20.RESULTS:A total of 421 cases of Geriatric age group were studied after selecting them through systematic Random sampling. All Geriatric patients attending medical and surgical specialties were included in the study except those discharged in Emergency Medicine. Out of total 421 cases, 268 (64%) were admitted to medical specialties while 153 (36%) cases were related to surgical specialties. Out of total cases studied 44% were in the age group of 60 -70yrs, 40% were in the age group of 70-80 yrs and 16% were &amp;amp;gt; 80 yrs of age. It was seen that among the selected cases 60-70 yrs age group was the largest one and &amp;amp;gt; 80yrs of age was the least one .The results were described with respect to variables ,as, DRESS AND GROOM that among the age group of 60-70yrs majority were able to dress and groom &amp;amp;lsquo;without any difficulty&amp;amp;rsquo;. In the age group of 70-80yrs majority (43.5%) Emergency Admission had &amp;amp;lsquo;some difficulty&amp;amp;rsquo; in dressing and grooming while (52.5%) Routine admission were &amp;amp;lsquo;without any difficulty&amp;amp;rsquo;. Among the age group of &amp;amp;gt; 80yrs majority having &amp;amp;lsquo;some difficulty&amp;amp;rsquo; in dressing and grooming. While as (41.4%) of the s routine admissions were having &amp;amp;lsquo;much difficulty&amp;amp;rsquo; in dressing and grooming.Studying the morbidity variable &amp;amp;lsquo;ARISING&amp;amp;rsquo; majority of patients in the age group of 60-70yrs had &amp;amp;lsquo;some difficulty&amp;lsquo; . The scenario in older group i.e &amp;amp;gt; 80 years majority experienced &amp;amp;lsquo;much difficulty&amp;amp;rsquo; in arising from sitting posture. In the age of 70-80yrs majority facing &amp;amp;lsquo;Some difficulty&amp;amp;rsquo; WALKING. Majority (100%) of patients above 80yrs of age faced &amp;amp;lsquo;much difficulty&amp;amp;rsquo; in walking . Also majority in the age group of 60-70yrs and 70-80yrs faced &amp;amp;lsquo;no difficulty&amp;amp;rsquo; in EATING while 76.3% of emergency patients and 48.3% of routine patients in the age group of &amp;amp;gt; 80yrs faced &amp;amp;lsquo;some difficulty&amp;amp;rsquo; . No patient in either of the three groups was seen with inability to eat.REACH In the age group of 80 or more majority faced &amp;amp;lsquo;much difficulty&amp;amp;rsquo; in reach. Above 80yrs of age significant percentage were &amp;amp;lsquo;unable&amp;amp;rsquo; to reach ( likert scale 4). AIDS OR DEVICES In age group of 60-70yrs majority were found not using any Aids or devices while 21.8% Emergency and 21.7% routine admissions were using walkers. The pattern was similar in the age group of 70-80yrs. Majority of Geriatric patients &amp;amp;gt; 80 years were found using multiple devices i.e walkers as well as wheel chairs to walk AND a good percentage of patients (18.4% in Emergency and 24.7% in Routine) were not using any devices at all. PAIN The above results shows that majority in age group of 60-70 experienced &amp;amp;lsquo;mild pain&amp;amp;rsquo; in the past week while &amp;amp;lsquo;severe pain&amp;amp;rsquo; was felt by majority of those age group of &amp;amp;gt; 80yrs .Significant %age i.e 21.1% in emergency and 20.7% in routine experienced &amp;amp;lsquo;very severe pain&amp;amp;rsquo; in the last week. CURRENT HEALTH STATUS majority in the age group &amp;amp;gt; 80yrs rated their current health status as &amp;amp;lsquo;poor&amp;amp;rsquo;. 21% patients in Emergency and 24% in Routine rated their health status as &amp;amp;lsquo;very poor&amp;amp;rsquo; and fitted at the extreme in likert scale. In the age group of 60-70yrs and 70-80 yrs majority of Geriatric patients rated their health status as &amp;amp;lsquo;not well&amp;amp;rsquo;. CONCLUSIONS:The study on conclusion establishes that Geriatric age group is associated with high morbidity and there is need for providing social support during hospitalization to the elderly patients.&amp;lt;/p&amp;gt;&lt;/p&gt;</p>