Results
A total of 250 older adult patients were admitted to the
cardiology/medicine department with the cardiac complaints and met
inclusion criteria during the study period. Out of 250 inpatients, 60%
(n=150) of the patients were males, the median age of the patient at the
time of hospital admission was 65 years (range 65- 86 years). About 64%
(n= 160) of the patients belonged to the age group of 65- 70 years,
followed by 17.6% (n=44) patients aged between 71- 75 years, whereas
only 8.8% (n=22) of the inpatients were above 80 years. A very high
proportion of the patients (67.2%, n=168) were found to be illiterate.
Approximately 16% (n=40) of the patients were a chronic smoker, and the
same proportion of patients were found to be a chronic alcoholic,
respectively. Table 1 represents the socio-demographic and clinical
characteristics of the older adult patients.
It was observed that on average, each patient had 3 diagnosis, and the
number of diagnosis ranged from one to seven. However, 36.8% (n=92) of
the patients were having ≥4 diagnosis during their hospital stay.
Moreover, patients have been categorized according to their length of
hospital stay as prolonged hospital stay may increase the risk of
adverse drug reaction. The median length of hospital stay was 6 days
(range 3- 20 days). Also, it was found that nearly one-sixth of the
older adult patients (64%, n=160) were prescribed with nine or more
than nine medications during their hospital stay. Most of the patients
were either on polypharmacy (5- 9 medications per day) or high- level
polypharmacy (>10 medications per day) during their
hospital stay. On the other hand, several comorbidities were documented
in patients. The majority of the older adult patients suffered from
chronic diseases such as Ischemic vascular disease (208 patients),
Dilated cardiomyopathy (46 patients), followed by 56 patients with
congestive heart failure. Figure 1 describes the prevalence of the
chronic disease in 250 older adult patients.
A significant decline in kidney functions is often observed in the
majority of the older adult patients. In our study, the mean creatinine
clearance was 45.62ml/min (range 5-156). It has been clarified in Beers
criteria that certain given medications either should be avoided or
their dosage should be adjusted after having an eye on the kidney
function or creatinine clearance of the patient. The mean serum
creatinine of the patient was 5.6mg/dl (range 2.4- 18). Creatinine
clearance (CrCl) was calculated with the help of Cockcroft- Gault
formula, and the mean CrCl was 12.75ml/min (range 4- 36). About 37.6%
(n= 94) of the patients were having CrCl less than 30ml/min followed by
33.6% (n=84) within the range between 31- 60 ml/min. A deficient
proportion of patients (4.8%, n=12) were having CrCl above 90ml/min.