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
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pubmed:14605944Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Viral lower respiratory tract infection in the elderly: a prospective in-hospital study.</title><author><name sortKey="Flamaing, J" sort="Flamaing, J" uniqKey="Flamaing J" first="J" last="Flamaing">J. Flamaing</name><affiliation><nlm:affiliation>Department of Geriatric Medicine, University Hospital Leuven, Herestraat 49, 3000 Leuven, Belgium. johan.flamaing@uz.kuleuven.ac.be</nlm:affiliation></affiliation></author><author><name sortKey="Engelmann, I" sort="Engelmann, I" uniqKey="Engelmann I" first="I" last="Engelmann">I. Engelmann</name></author><author><name sortKey="Joosten, E" sort="Joosten, E" uniqKey="Joosten E" first="E" last="Joosten">E. Joosten</name></author><author><name sortKey="Van Ranst, M" sort="Van Ranst, M" uniqKey="Van Ranst M" first="M" last="Van Ranst">M. Van Ranst</name></author><author><name sortKey="Verhaegen, J" sort="Verhaegen, J" uniqKey="Verhaegen J" first="J" last="Verhaegen">J. Verhaegen</name></author><author><name sortKey="Peetermans, W E" sort="Peetermans, W E" uniqKey="Peetermans W" first="W E" last="Peetermans">W E Peetermans</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2003">2003</date><idno type="RBID">pubmed:14605944</idno><idno type="pmid">14605944</idno><idno type="doi">10.1007/s10096-003-1042-z</idno><idno type="wicri:Area/Main/Corpus">000101</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000101</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Viral lower respiratory tract infection in the elderly: a prospective in-hospital study.</title><author><name sortKey="Flamaing, J" sort="Flamaing, J" uniqKey="Flamaing J" first="J" last="Flamaing">J. Flamaing</name><affiliation><nlm:affiliation>Department of Geriatric Medicine, University Hospital Leuven, Herestraat 49, 3000 Leuven, Belgium. johan.flamaing@uz.kuleuven.ac.be</nlm:affiliation></affiliation></author><author><name sortKey="Engelmann, I" sort="Engelmann, I" uniqKey="Engelmann I" first="I" last="Engelmann">I. Engelmann</name></author><author><name sortKey="Joosten, E" sort="Joosten, E" uniqKey="Joosten E" first="E" last="Joosten">E. Joosten</name></author><author><name sortKey="Van Ranst, M" sort="Van Ranst, M" uniqKey="Van Ranst M" first="M" last="Van Ranst">M. Van Ranst</name></author><author><name sortKey="Verhaegen, J" sort="Verhaegen, J" uniqKey="Verhaegen J" first="J" last="Verhaegen">J. Verhaegen</name></author><author><name sortKey="Peetermans, W E" sort="Peetermans, W E" uniqKey="Peetermans W" first="W E" last="Peetermans">W E Peetermans</name></author></analytic><series><title level="j">European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology</title><idno type="ISSN">0934-9723</idno><imprint><date when="2003" type="published">2003</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Age Factors</term><term>Aged</term><term>Aged, 80 and over</term><term>Belgium (epidemiology)</term><term>Cohort Studies</term><term>Female</term><term>Geriatric Assessment</term><term>Hospital Mortality (trends)</term><term>Hospitalization (statistics & numerical data)</term><term>Humans</term><term>Incidence</term><term>Logistic Models</term><term>Male</term><term>Pneumonia, Viral (epidemiology)</term><term>Pneumonia, Viral (virology)</term><term>Probability</term><term>Prognosis</term><term>Prospective Studies</term><term>Respiratory Tract Infections (epidemiology)</term><term>Respiratory Tract Infections (virology)</term><term>Risk Assessment</term><term>Statistics, Nonparametric</term><term>Survival Analysis</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Belgium</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Pneumonia, Viral</term><term>Respiratory Tract Infections</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Hospitalization</term></keywords><keywords scheme="MESH" qualifier="trends" xml:lang="en"><term>Hospital Mortality</term></keywords><keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Pneumonia, Viral</term><term>Respiratory Tract Infections</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Age Factors</term><term>Aged</term><term>Aged, 80 and over</term><term>Cohort Studies</term><term>Female</term><term>Geriatric Assessment</term><term>Humans</term><term>Incidence</term><term>Logistic Models</term><term>Male</term><term>Probability</term><term>Prognosis</term><term>Prospective Studies</term><term>Risk Assessment</term><term>Statistics, Nonparametric</term><term>Survival Analysis</term></keywords></textClass></profileDesc></teiHeader><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></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">14605944</PMID><DateCompleted><Year>2004</Year><Month>02</Month><Day>20</Day></DateCompleted><DateRevised><Year>2020</Year><Month>03</Month><Day>24</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Print">0934-9723</ISSN><JournalIssue CitedMedium="Print"><Volume>22</Volume><Issue>12</Issue><PubDate><Year>2003</Year><Month>Dec</Month></PubDate></JournalIssue><Title>European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology</Title><ISOAbbreviation>Eur. J. Clin. Microbiol. Infect. Dis.</ISOAbbreviation></Journal><ArticleTitle>Viral lower respiratory tract infection in the elderly: a prospective in-hospital study.</ArticleTitle><Pagination><MedlinePgn>720-5</MedlinePgn></Pagination><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></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Flamaing</LastName><ForeName>J</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Geriatric Medicine, University Hospital Leuven, Herestraat 49, 3000 Leuven, Belgium. johan.flamaing@uz.kuleuven.ac.be</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Engelmann</LastName><ForeName>I</ForeName><Initials>I</Initials></Author><Author ValidYN="Y"><LastName>Joosten</LastName><ForeName>E</ForeName><Initials>E</Initials></Author><Author ValidYN="Y"><LastName>Van Ranst</LastName><ForeName>M</ForeName><Initials>M</Initials></Author><Author ValidYN="Y"><LastName>Verhaegen</LastName><ForeName>J</ForeName><Initials>J</Initials></Author><Author ValidYN="Y"><LastName>Peetermans</LastName><ForeName>W E</ForeName><Initials>WE</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2003</Year><Month>11</Month><Day>06</Day></ArticleDate></Article><MedlineJournalInfo><Country>Germany</Country><MedlineTA>Eur J Clin Microbiol Infect Dis</MedlineTA><NlmUniqueID>8804297</NlmUniqueID><ISSNLinking>0934-9723</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000367" MajorTopicYN="N">Age Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001530" MajorTopicYN="N" Type="Geographic">Belgium</DescriptorName><QualifierName UI="Q000453" 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