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Evaluation of Documentation of Admissions into A Geriatrics Unit in Nigeria: 2014-2018.

O Akoria, F Osian, B Akene, E Ugorji, O Emore

West African journal of medicine(2021)

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Abstract
BACKGROUND AND AIMS:The Geriatrics Unit in University of Benin Teaching Hospital (UBTH), Nigeria was established in March 2014 to provide specialized healthcare to older persons. We undertook a review of admissions into the unit in order to characterize disease patterns, identify gaps and make recommendations for service improvement. METHODS:Admissions from April 1, 2014, to March 31, 2018, were classified into age groups. Diseases were classified using the International Classification of Diseases (ICD-10 CM). Challenges with documentation were identified and summarized. RESULTS:All documentation and data extraction were manually done; some data sources were hard to reach. A total of 835 elderly patients were admitted during the period under review, of whom 51.8% were females. Almost half of patients (48.1%) were aged 60-74 years; 15% were 85 years and above. "Sepsis, unspecified organism" (ICD-10 code A41.9) was the leading single diagnosis (10.2%). Pneumonia (ICD-10 code J18) and urinary tract infection (ICD-10 code N39.0) were the most frequent infections that caused sepsis. Diabetes and hypertension contributed 16.8% and 3.9%, respectively. Delirium, vascular dementia and Alzheimer's disease accounted for 4%, 0.8% and 0.3%, respectively. CONCLUSIONS:This evaluation enabled the description of disease patterns in our geriatrics unit, and revealed documentation gaps. Based on our findings, we argue for interventions to improve documentation and to reduce the burden of infections, diabetes and hypertension which were the major causes of disease in older persons in our unit.
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