Viral lower respiratory tract infection in the elderly: a prospective in-hospital study.
Identifieur interne : 000101 ( Main/Corpus ); précédent : 000100; suivant : 000102Viral lower respiratory tract infection in the elderly: a prospective in-hospital study.
Auteurs : J. Flamaing ; I. Engelmann ; E. Joosten ; M. Van Ranst ; J. Verhaegen ; W E PeetermansSource :
- European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology [ 0934-9723 ] ; 2003.
English descriptors
- KwdEn :
- Age Factors, Aged, Aged, 80 and over, Belgium (epidemiology), Cohort Studies, Female, Geriatric Assessment, Hospital Mortality (trends), Hospitalization (statistics & numerical data), Humans, Incidence, Logistic Models, Male, Pneumonia, Viral (epidemiology), Pneumonia, Viral (virology), Probability, Prognosis, Prospective Studies, Respiratory Tract Infections (epidemiology), Respiratory Tract Infections (virology), Risk Assessment, Statistics, Nonparametric, Survival Analysis.
- MESH :
- geographic , epidemiology : Belgium.
- epidemiology : Pneumonia, Viral, Respiratory Tract Infections.
- statistics & numerical data : Hospitalization.
- trends : Hospital Mortality.
- virology : Pneumonia, Viral, Respiratory Tract Infections.
- Age Factors, Aged, Aged, 80 and over, Cohort Studies, Female, Geriatric Assessment, Humans, Incidence, Logistic Models, Male, Probability, Prognosis, Prospective Studies, Risk Assessment, Statistics, Nonparametric, Survival Analysis.
Abstract
The objective of this prospective study was to evaluate the clinical and laboratory parameters distinguishing viral from nonviral lower respiratory tract infection in elderly patients and to determine the yield of virological diagnostics in elderly patients with lower respiratory tract infection. The study was conducted in a 184-bed geriatric department in a university hospital during 4 winter months. All consecutive elderly persons admitted with a lower respiratory tract infection were included in the study. Clinical and laboratory parameters, a nasopharyngeal swab, and serological results for respiratory viruses were obtained for all participants. Available blood and sputum cultures were analysed. A total of 165 elderly persons (mean age, 82+/-6.8 years) were hospitalised with a lower respiratory tract infection. Familial flu-like illness (OR, 4.25; 95%CI, 1.4-13), better functionality (OR, 4; 95%CI, 1.3-14.15), and leucocyte count <10(10)/l (OR, 3; 95%CI, 1.3-7.1) were predictive for viral lower respiratory tract infection. Sixty (36.5%) definite diagnoses (positive blood culture, viral culture, or serological test) and seven (4.2%) probable diagnoses (positive sputum culture) were obtained. An early diagnosis (within 72 h) was possible in 38 (23%) and a late diagnosis in 29 (17.6%) participants. A nasopharyngeal swab contributed in 60.5% of the cases to an early diagnosis. Viral culture identified half (22/43) of the lower respiratory tract infections caused by influenza but only one of six lower respiratory tract infections caused by respiratory syncytial virus. In conclusion, a history of flu-like illness in family members and a total leucocyte count within normal limits makes a viral cause more likely in elderly people hospitalised with a lower respiratory tract infection during winter. Viral culture and rapid antigen detection are insensitive in elderly patients hospitalised with a lower respiratory tract infection.
DOI: 10.1007/s10096-003-1042-z
PubMed: 14605944
Links to Exploration step
pubmed:14605944Le document en format XML
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<front><div type="abstract" xml:lang="en">The objective of this prospective study was to evaluate the clinical and laboratory parameters distinguishing viral from nonviral lower respiratory tract infection in elderly patients and to determine the yield of virological diagnostics in elderly patients with lower respiratory tract infection. The study was conducted in a 184-bed geriatric department in a university hospital during 4 winter months. All consecutive elderly persons admitted with a lower respiratory tract infection were included in the study. Clinical and laboratory parameters, a nasopharyngeal swab, and serological results for respiratory viruses were obtained for all participants. Available blood and sputum cultures were analysed. A total of 165 elderly persons (mean age, 82+/-6.8 years) were hospitalised with a lower respiratory tract infection. Familial flu-like illness (OR, 4.25; 95%CI, 1.4-13), better functionality (OR, 4; 95%CI, 1.3-14.15), and leucocyte count <10(10)/l (OR, 3; 95%CI, 1.3-7.1) were predictive for viral lower respiratory tract infection. Sixty (36.5%) definite diagnoses (positive blood culture, viral culture, or serological test) and seven (4.2%) probable diagnoses (positive sputum culture) were obtained. An early diagnosis (within 72 h) was possible in 38 (23%) and a late diagnosis in 29 (17.6%) participants. A nasopharyngeal swab contributed in 60.5% of the cases to an early diagnosis. Viral culture identified half (22/43) of the lower respiratory tract infections caused by influenza but only one of six lower respiratory tract infections caused by respiratory syncytial virus. In conclusion, a history of flu-like illness in family members and a total leucocyte count within normal limits makes a viral cause more likely in elderly people hospitalised with a lower respiratory tract infection during winter. Viral culture and rapid antigen detection are insensitive in elderly patients hospitalised with a lower respiratory tract infection.</div>
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<Abstract><AbstractText>The objective of this prospective study was to evaluate the clinical and laboratory parameters distinguishing viral from nonviral lower respiratory tract infection in elderly patients and to determine the yield of virological diagnostics in elderly patients with lower respiratory tract infection. The study was conducted in a 184-bed geriatric department in a university hospital during 4 winter months. All consecutive elderly persons admitted with a lower respiratory tract infection were included in the study. Clinical and laboratory parameters, a nasopharyngeal swab, and serological results for respiratory viruses were obtained for all participants. Available blood and sputum cultures were analysed. A total of 165 elderly persons (mean age, 82+/-6.8 years) were hospitalised with a lower respiratory tract infection. Familial flu-like illness (OR, 4.25; 95%CI, 1.4-13), better functionality (OR, 4; 95%CI, 1.3-14.15), and leucocyte count <10(10)/l (OR, 3; 95%CI, 1.3-7.1) were predictive for viral lower respiratory tract infection. Sixty (36.5%) definite diagnoses (positive blood culture, viral culture, or serological test) and seven (4.2%) probable diagnoses (positive sputum culture) were obtained. An early diagnosis (within 72 h) was possible in 38 (23%) and a late diagnosis in 29 (17.6%) participants. A nasopharyngeal swab contributed in 60.5% of the cases to an early diagnosis. Viral culture identified half (22/43) of the lower respiratory tract infections caused by influenza but only one of six lower respiratory tract infections caused by respiratory syncytial virus. In conclusion, a history of flu-like illness in family members and a total leucocyte count within normal limits makes a viral cause more likely in elderly people hospitalised with a lower respiratory tract infection during winter. Viral culture and rapid antigen detection are insensitive in elderly patients hospitalised with a lower respiratory tract infection.</AbstractText>
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