Comparison of clinical manifestations and outcome of community-acquired bloodstream infections among the oldest old, elderly, and adult patients

Chien Chang Lee, Shey Ying Chen, I. Jing Chang, Shyr Chyr Chen, Shwu Chong Wu

研究成果: 雜誌貢獻文章

85 引文 (Scopus)

摘要

Valid studies comparing the clinical characteristics among adult, elderly, and the oldest old bacteremic patients are lacking. We conducted a prospective, observational study in the emergency department (ED) of a university medical center between June 2001 and June 2002. All patients >18 years of age who registered in the ED with a clinically significant, culture-positive, bloodstream infection (BSI) were enrolled. Patients were divided into 3 groups based on age: 1) oldest old (≥85 yr), 2) elderly (65-84 yr), and 3) adult (18-64 yr). The clinical and laboratory manifestations and 30-day mortality were recorded. Group comparisons were performed using the chi-square test or analysis of variance (ANOVA) test, as indicated. Survival was analyzed using the Kaplan-Meier method and the Cox-regression model, adjusted for potential confounders.A total of 890 cases of community-acquired BSI were eligible for analysis. Compared to the adult group, both the elderly and the oldest old patients had more atypical clinical manifestations, a higher propensity to develop organ failure, and a worse prognosis. Elderly patients had significantly less tachycardia (p = 0.001), but more acute respiratory (p = 0.007) and renal failure (p = 0.037); the oldest old patients had more afebrile episodes (p = 0.006), leukocytosis (p = 0.012), and more patients developed respiratory failure (p = 0.009), acute renal failure (p = 0.011), septic shock (p = 0.022), and altered mental status (p = 0.013). Urinary tract infections were the main source of BSI for both the elderly and oldest old, while the oldest old patients had significantly more pneumonia than the elderly or adults.As a group, older patients had fewer signs and symptoms of BSI, but a higher risk of organ failure and a worse prognosis than younger patients.

原文英語
頁(從 - 到)138-144
頁數7
期刊Medicine
86
發行號3
DOIs
出版狀態已發佈 - 五月 1 2007
對外發佈Yes

指紋

Community-Acquired Infections
Hospital Emergency Service
Infection
Leukocytosis
Chi-Square Distribution
Septic Shock
Proportional Hazards Models
Acute Kidney Injury
Tachycardia
Urinary Tract Infections
Respiratory Insufficiency
Signs and Symptoms
Observational Studies
Renal Insufficiency
Pneumonia
Analysis of Variance
Prospective Studies

ASJC Scopus subject areas

  • Medicine(all)

引用此文

Comparison of clinical manifestations and outcome of community-acquired bloodstream infections among the oldest old, elderly, and adult patients. / Lee, Chien Chang; Chen, Shey Ying; Chang, I. Jing; Chen, Shyr Chyr; Wu, Shwu Chong.

於: Medicine, 卷 86, 編號 3, 01.05.2007, p. 138-144.

研究成果: 雜誌貢獻文章

Lee, Chien Chang ; Chen, Shey Ying ; Chang, I. Jing ; Chen, Shyr Chyr ; Wu, Shwu Chong. / Comparison of clinical manifestations and outcome of community-acquired bloodstream infections among the oldest old, elderly, and adult patients. 於: Medicine. 2007 ; 卷 86, 編號 3. 頁 138-144.
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AB - Valid studies comparing the clinical characteristics among adult, elderly, and the oldest old bacteremic patients are lacking. We conducted a prospective, observational study in the emergency department (ED) of a university medical center between June 2001 and June 2002. All patients >18 years of age who registered in the ED with a clinically significant, culture-positive, bloodstream infection (BSI) were enrolled. Patients were divided into 3 groups based on age: 1) oldest old (≥85 yr), 2) elderly (65-84 yr), and 3) adult (18-64 yr). The clinical and laboratory manifestations and 30-day mortality were recorded. Group comparisons were performed using the chi-square test or analysis of variance (ANOVA) test, as indicated. Survival was analyzed using the Kaplan-Meier method and the Cox-regression model, adjusted for potential confounders.A total of 890 cases of community-acquired BSI were eligible for analysis. Compared to the adult group, both the elderly and the oldest old patients had more atypical clinical manifestations, a higher propensity to develop organ failure, and a worse prognosis. Elderly patients had significantly less tachycardia (p = 0.001), but more acute respiratory (p = 0.007) and renal failure (p = 0.037); the oldest old patients had more afebrile episodes (p = 0.006), leukocytosis (p = 0.012), and more patients developed respiratory failure (p = 0.009), acute renal failure (p = 0.011), septic shock (p = 0.022), and altered mental status (p = 0.013). Urinary tract infections were the main source of BSI for both the elderly and oldest old, while the oldest old patients had significantly more pneumonia than the elderly or adults.As a group, older patients had fewer signs and symptoms of BSI, but a higher risk of organ failure and a worse prognosis than younger patients.

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