DIGESTIVE DISEASES IN ELDERLY AND FACTORS ASSOCIATED WITH LENGTH OF STAY IN THE HEPATOLOGY AND GASTROENTEROLOGY UNIT OF THE CAMPUS TEACHING HOSPITAL OF LOME (TOGO)

LAWSON-ANANISSOH, Laté Mawuli; BOUGLOUGA, Oumboma; BAGNY, Aklesso; EL-HADJI YAKOUBOU, Rafiou; KAAGA, Laconi; REDAH, Datouda

doi:10.1590/S0004-2803.201800000-80

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ORIGINAL ARTICLE • Arq. Gastroenterol. 55 (04) • Oct-Dec 2018 • https://doi.org/10.1590/S0004-2803.201800000-80 linkcopy

DIGESTIVE DISEASES IN ELDERLY AND FACTORS ASSOCIATED WITH LENGTH OF STAY IN THE HEPATOLOGY AND GASTROENTEROLOGY UNIT OF THE CAMPUS TEACHING HOSPITAL OF LOME (TOGO)

Doenças digestivas em idosos e fatores associados à duração da permanência na unidade Hepatologia e Gastroenterologia do Hospital Universitário de Ensino de Lomé (Togo)

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

BACKGROUND: The digestive pathologies are frequent in the elderly and often have a latent and atypical symptomatology.

OBJECTIVE: To assess the epidemiological and evolutionary current data on digestive diseases in the elderly, and look for factors associated with length of hospital stay.

METHODS: Retrospective study of 10 years, including patients aged 60 and over hospitalized for digestive diseases in the Gastroenterology Department of the Campus Teaching Hospital of Lome, Togo.

RESULTS: Of 5933 hospitalized patients, there were 1054 patients (17.8%) aged 60 years and over with a digestive pathology (526 men and 528 women). The average age was 69.5 years ±7.9 ranging from 60 to 105 years. The average length of hospital stay was 7.45 days ±6.2 ranging from 1 to 44 days. HIV prevalence was 2.4%. In order of decreasing frequency, there were hepatobiliary pathologies (54.3%) with a predominance of cirrhosis and liver cancer, eso-gastroduodenal pathologies (23.1%) with predominance of ulcers, gastric cancer and esophageal cancer, intestinal pathologies (8.7%) with a predominance of food poisoning, pancreatic pathologies (4.2%) with a predominance of pancreatic cancer and peritoneal pathologies (1.4%). Gastric cancer was the second digestive cancer found after liver cancer. Pancreatic head cancer was the second disease after gastric cancer which need a transfer in a surgical ward (P=0.031). There were 204 deaths (19.4%). The longest duration of hospitalization was due to gastric cancer (9.16 days).

CONCLUSION: Hepatobiliary diseases were the most frequent and associated with a high death rate and a long hospital stay.

HEADINGS: Aged; Digestive system diseases; Hospitalization; Togo

	Population (n)	Percentage (%)
Hepatobiliary pathologies
Cirrhosis	290	27.5
Hepatocarcinoma	238	22.5
Liver metastases	21	1.9
Cholangiocarcinoma	7	0.7
Toxic hepatitis	7	0.7
Hepatic abscess	5	0.5
Hépatonephritis	5	0.5

Eso-gastroduodenal pathologies
Esophageal cancer	13	1.2
Gastroesophageal reflux	11	1.0
Esophagitis	9	0.9
Mallory-Weiss syndrome	4	0.4
Gastric cancer	61	5.8
Gastritis	43	4.1
Gastric ulcer	38	3.6
Gastric polyp	2	0.2
Cardiac cancer	1	0.1
Bulbar ulcer	39	3.7
Bulbo-duodenitis	19	1.8
Bulb lymphoma	3	0.3

Intestinal and anal pathologies
Food poisoning	41	3.9
Colorectal cancer	15	1.4
Functional colopathy	13	1.2
Diverticulosis of the colon	6	0.6
Colitis	2	0.2
Rectal necrosis	1	0.1
Hemorrhoids	12	1.1
Anal cancer	2	0.2

Pancreatic pathologies
Pancreatic cancer	40	3.8
Chronic pancreatitis	2	0.2
Acute pancreatitis	2	0.2

Pathologies of the peritoneum
Peritoneal tuberculosis	15	1.4

Other pathologies
General evolution of digestive pathologies	87	8.3
Death	204	19.4
Discharge	12	1.1
Exit	788	74.8
Transfer	50	4.7

	Death		Discharge		Exit		Transfer		P value
	n	%	n	%	n	%	n	%
Age groups									0.3228⁺
[60-70[	108	52.9	7	58.4	430	54.5	24	48.0
[70-80[	64	31.4	3	25.0	251	31.9	15	30.0
[80-90[	30	14.8	1	8.3	83	10.5	10	20.0
90 years and over	2	0.9	1	8.3	24	3.1	1	2.0
Total	204	100	12	100	788	100	50	100

Digestives pathologies									<0.0001⁺
Hepatocarcinoma	77	37.7	2	16.7	158	20.1	1	2
Cirrhosis	75	36.8	4	33.3	206	26.1	5	10
Gastritis	1	0.5	0	0.0	42	5.3	0	0.0
Gastric cancer	6	2.9	0	0.0	47	5.9	8	16
Food poisining	0	0.0	0	0.0	40	5.1	1	2
Cancer of the head of the pancreas	9	4.4	0	0.0	22	2.8	6	12
Bulbar ulcer	2	0.9	1	8.3	36	4.6	0	0.0
Gastric ulcer	1	0.5	0	0.0	36	4.6	1	2
Other pathologies	33	16.2	5	41.7	197	25	28	56
Total	204	100	12	100	788	100	50	100

	n	Average length (day)	P value
Age groups (years)			0.2080
[60-70[	569	7.77
[70-80[	333	7.30
[80-90[	124	6.71
90 years and over	28	6.18

Pathological groups			0.0049
Hepatobiliary pathologies	574	8.03
Intestinal pathologies	136	6.01
Eso-gastroduodenal pathologies	279	6.95
Pancreatic pathologies	44	8.27
Pathologies of the peritoneum	8	8.25

Main digestives pathologies			<0.0001
Hepatocarcinoma	238	6.92
Cirrhosis	290	8.96
Gastritis	43	6.28
Gastric cancer	61	9.16
Food poisoning	41	3.22
Cancer of the head of the pancreas	37	7.92
Bulbar ulcer	39	7.51
Gastric ulcer	38	6.68

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