Mortalidad en la mayoría comunitaria: coeficiente y factores associados

Estudio longitudinal y analítico. La recogida de datos, en la línea de base, ha sido realizada en el domicilio del anciano. La primera onda ocurrió tras 42 meses. Realizó recogida complementar para identificación de la causa de la muerte. Variables analizadas: demográficas, sociales, económicas y clínicas. Para análisis de los datos, se utilizó regresión logística.

Resultados:

El coeficiente de mortalidad fue 7,9%. Las variables relacionadas a la mortalidad fueron: longevidad, no saber leer, ausencia de práctica religiosa, accidente vascular encefálico, realización de consulta e internación en los últimos 12 meses. Los principales equipos de causas básicas de muerte fueron causas mal definidas y las no especificadas de mortalidad; enfermedades del aparato respiratorio; y neoplasias.

Conclusión:

El coeficiente de mortalidad en ancianos comunitarios se mostró menor en comparación a los estudios nacionales e internacionales investigados.

Descriptores:
Mortalidad; Anciano; Salud Pública; Enfermería Geriátrica; Enfermería en Salud Comunitaria

Independent Variables			Death				p value
	Sample		Yes		No
	n	%	n	%	n	%
Demographic Characteristics
Gender							0.552
Male	241	35.2	21	8.7	220	91.3
Female	444	64.8	33	7.4	441	92.6
Age group							< 0.001
Up to 79 years old	579	84.5	30	5.2	549	94.8
≥ 80 years old	106	15.5	24	22.6	82	77.4
Skin color							0.748
White	215	31.4	18	8.4	197	91.6
Non-white	470	68.6	36	7.7	434	92.3
Social Characteristics
Marital status							0.178
With partner	352	51.4	23	6.5	329	93.5
Without partner	333	48.6	31	9.3	302	90.7
Family arrangement							0.813
Living alone	83	12.1	6	7.2	77	92.8
Not living alone	602	87.9	48	8.0	554	92.0
Education							0.023
> 4 years	163	23.8	6	3.7	157	157
Up to 4 years	522	76.2	48	9.2	474	90.8
Literacy							< 0.001
Ability to read	489	71.4	27	5.5	462	94.5
Inability to read	196	28.6	27	13.8	169	86.2
Religious practice							< 0.001
Yes	561	81.9	34	6.1	527	93.9
No	124	18.1	20	16.1	104	83.9
Economic Characteristics
Own income							0.072
Yes	609	88.9	52	8.5	557	91.5
No	76	11.1	2	2.6	74	97.4
Monthly Family income							0.266
> 1 salary*	489	71.4	35	7.2	454	92.8
Up to 1 salary	196	28.6	19	9.7	177	90.3

Independent Variables			Death				p value
	Sample		Yes		No
	n	%	n	%	n	%
Clinical Characteristics
Hypertension							0.922
Yes	486	70.9	38	7.8	448	92.2
Noo	199	29.1	16	8.0	183	92.0
Diabetes Mellitus							0.180
Yes	153	22.3	16	10.5	137	89.5
No	532	77.7	38	7.1	494	92.9
Heart Disease							0.003
Yes	164	23.9	22	13.4	142	86.6
No	521	76.1	32	6.1	489	93.9
Osteoarticular disease							0.766
Yes	241	35.2	20	8.3	221	91.7
No	444	64.8	34	7.7	410	92.3
Osteoporosis							0.139
Yes	171	25.0	18	10.5	153	89.5
No	514	75.0	36	7.0	478	93.0
Neoplasm							0.831
Yes	22	3.2	2	9.1	20	90.9
No	663	96.8	52	7.8	611	92.2
Stroke
Yes	38	5.5	10	26.3	28	73.7
No	647	94.5	44	6.8	603	93.2
Pulmonary embolism							0.071
Yes	8	1.2	2	25.0	6	75.0
No	677	98.8	52	7.7	625	92.3
Chronic obstructive pulmonary disease
Yes	30	4.4	3	10.0	27	90.0
No	655	95.6	51	7.8	604	92.2
Asthma							0.497
Yes	37	5.4	4	10.8	33	89.2
No	648	94.6	50	7.7	598	92.3
Polypathology							0.001
Yes	7	1.0	3	42.9	4	57.1
No	678	99.0	51	7.5	627	92.5
Self-perception of health							0.119
Positive	593	86.6	43	7.3	550	92.7
Negative	92	13.4	11	12.0	81	88.0
Weight loss							0.018
Yes	253	36.9	28	11.1	225	88.9
No	432	63.1	26	6.0	406	94.0
Smoking							0.956
Yes	302	44.1	24	7.9	278	92.1
No	383	55.9	30	7.8	353	92.2
Depression							0.486
Yes	200	29.2	18	9.0	182	91.0
No	485	70.8	36	7.4	449	92.6
Has a caregiver							< 0.001
Yes	117	17.1	22	18.8	95	81.2
No	568	82.9	32	5.6	536	94.4
Fall in the last 12 months							0.035
Yes	194	28.3	22	11.3	172	88.7
No	491	71.7	32	6.5	459	93.5
Consultation in the last 12 months							0.036
Yes	616	89.9	53	8.6	563	91.4
No	69	10.1	1	1.4	68	98.6
Hospitalization in the last 12 months							< 0.001
Yes	121	17.7	21	17.4	100	82.6
No	564	82.3	33	5.9	531	94.1
Polypharmacy							0.002
≥ 5 Medications	161	23.5	22	13.7	139	86.3
< 5 Medications	524	76.5	32	6.1	492	93.9
Frailty							< 0.001
Frail	243	35.5	33	13.6	210	86.4
Not frail	442	64.5	21	4.8	421	95.2
Basic Activities							< 0.001
Dependent	62	9.1	13	21.0	49	79.0
Independent	623	90.9	41	6.6	582	93.4
Instrumental Activities							0.001
Dependent	296	43.2	35	11.8	261	88.2
Independent	389	56.8	19	4.9	370	95.1

Variable	OR (adjusted)	CI (95%)	pvalue
Age
Up to 79 years old	1
≥ 80 years old	4.12	2.18-7.79	< 0.001
Literacy
Ability to read	1
Inability to read	2.25	1.21-4.19	0.010
Religious Practice
Yes	1
No	2.38	1.23-4.60	0.010
Stroke
No	1
Yes	4.10	1.71-9.83	0.002
Consultation in the last 12 months
No	1	1.06-68.45	< 0.001
Yes	8.51
Hospitalizations in the last 12 months
No	1	1.42-5.10	0.002
Yes	2.69

Groups of causes	Sample
Groups of causes	n	%
Diseases of the circulatory system	4	7.4
Diseases of the digestive tract	3	5.5
Diseases of the respiratory system	17	31.5
External causes of mortality	1	1.9
Neoplasms	5	9.3
Other ill-defined and unspecified causes of mortality	24	44.4
Total	54	100

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[1] Corresponding author: Sarah Caroline Oliveira de Souza Boitrago. E-mail: scosouza@hotmail.com