Behavior of hospitalized severe influenza cases according to the outcome variable in Catalonia, Spain, during the 2017–2018 season

AbstractInfluenza is an important cause of severe illness and death among patients with underlying medical conditions and in the elderly. The aim of this study was to investigate factors associated with ICU admission and death in patients hospitalized with severe laboratory-confirmed influenza during the 2017–2018 season in Catalonia. An observational epidemiological case-to-case study was carried out. Reported cases of severe laboratory-confirmed influenza requiring hospitalization in 2017–2018 influenza season were included. Mixed-effects regression analysis was used to estimate the factors associated with ICU admission and death. A total of 1306 cases of hospitalized severe influenza cases were included, of whom 175 (13.4%) died and 217 (16.6%) were ICU admitted. Age 65–74 years and ≥ 75 years and having ≥ 2 comorbidities were positively associated with death (aOR 3.19; 95%CI 1.19–8.50, aOR 6.95, 95%CI 2.76–1.80 and aOR 1.99; 95%CI 1.12–3.52, respectively). Neuraminidase inhibitor treatment and pneumonia were negatively associated with death. The 65–74 years and ≥ 75 years age groups were negatively associated with ICU admission (aOR 0.41; 95%CI 0.23–0.74 and aOR 0.30; 95%CI 0.17–0.53, respectively). A factor positively associated with ICU admission was neuraminidase inhibitor treatment. Our results support the need to investigate the worst outcomes of hospitalized severe cases, distinguishing between death and ICU admission.

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Oseltamivir Use Among Children and Adults Hospitalized With Community-Acquired Pneumonia

Open Forum Infectious Diseases ◽

10.1093/ofid/ofw254 ◽

2016 ◽

Vol 4 (1) ◽

Cited By ~ 2

Author(s):

Ikwo K. Oboho ◽

Anna Bramley ◽

Lyn Finelli ◽

Alicia Fry ◽

Krow Ampofo ◽

...

Keyword(s):

Intensive Care Unit ◽

Differential Diagnosis ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Influenza Season ◽

Community Acquired Pneumonia ◽

Severe Illness ◽

Factors Associated ◽

Icu Admission ◽

Clinician Education

Abstract Background Data on oseltamivir treatment among hospitalized community-acquired pneumonia (CAP) patients are limited. Methods Patients hospitalized with CAP at 6 hospitals during the 2010−2012 influenza seasons were included. We assessed factors associated with oseltamivir treatment using logistic regression. Results Oseltamivir treatment was provided to 89 of 1627 (5%) children (<18 years) and 143 of 1051 (14%) adults. Among those with positive clinician-ordered influenza tests, 39 of 61 (64%) children and 37 of 48 (77%) adults received oseltamivir. Among children, oseltamivir treatment was associated with hospital A (adjusted odds ratio [aOR], 2.76; 95% confidence interval [CI], 1.36−4.88), clinician-ordered testing performed (aOR, 2.44; 95% CI, 1.47−5.19), intensive care unit (ICU) admission (aOR, 2.09; 95% CI, 1.27−3.45), and age ≥2 years (aOR, 1.43; 95% CI, 1.16−1.76). Among adults, oseltamivir treatment was associated with clinician-ordered testing performed (aOR, 8.38; 95% CI, 4.64−15.12), hospitals D and E (aOR, 3.46−5.11; 95% CI, 1.75−11.01), Hispanic ethnicity (aOR, 2.06; 95% CI, 1.18−3.59), and ICU admission (aOR, 2.05; 95% CI, 1.34−3.13). Conclusions Among patients hospitalized with CAP during influenza season, oseltamivir treatment was moderate overall and associated with clinician-ordered testing, severe illness, and specific hospitals. Increased clinician education is needed to include influenza in the differential diagnosis for hospitalized CAP patients and to test and treat patients empirically if influenza is suspected.

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Knowledge about mammography and associated factors: population surveys with female adults and elderly

Revista Brasileira de Epidemiologia ◽

10.1590/s1415-790x2013000400013 ◽

2013 ◽

Vol 16 (4) ◽

pp. 930-942 ◽

Cited By ~ 9

Author(s):

Ione Jayce Ceola Schneider ◽

Marui Weber Corseuil ◽

Antonio Fernando Boing ◽

Eleonora d'Orsi

Keyword(s):

Associated Factors ◽

Elderly Women ◽

Descriptive Analysis ◽

Age Groups ◽

The Elderly ◽

Cancer Information ◽

Population Surveys ◽

Factors Associated ◽

Younger Age ◽

Adjusted Model

The purpose of this paper is to describe the knowledge about mammography and to identify associated factors in female adults and elderly. Data were obtained from two population surveys, one with female adults and another with elderly women from Florianópolis (SC) in 2009 - 2010. A descriptive analysis of the variables was carried out, the appropriate mean of responses about mammography was estimated and crude and adjusted Poisson regression was conducted to identify associated factors. Among adults, 23.1% answered all of the questions appropriately and the appropriate average responses was 7.2 (95%CI 7.1 - 7.3) in a total of 9. In the adjusted model, older age, higher education and income were associated with knowledge about mammography. For the elderly, 15.3% answered all questions appropriately and the average of appropriate responses was 6.4 (95%CI 5.2 - 6.5) and the factors associated with knowledge about mammography in the adjusted model were younger age groups, increased education and income, and identification of mammography as the main diagnostic method for breast cancer. Information about mammography can neither be transmitted in a clear way nor be easily understood; there are also demographic and socioeconomic differences concerning the knowledge about the exam.

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Prevalence and Risk Factors Associated with Malaria among Children Aged Six Months to 14 Years Old in Rwanda: Evidence from 2017 Rwanda Malaria Indicator Survey

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17217975 ◽

2020 ◽

Vol 17 (21) ◽

pp. 7975

Author(s):

Faustin Habyarimana ◽

Shaun Ramroop

Keyword(s):

Age Groups ◽

Construction Materials ◽

Indoor Residual Spraying ◽

Outcome Variable ◽

Bed Nets ◽

Factors Associated ◽

Malaria Indicator Survey ◽

Complex Design ◽

Poor Families ◽

Household Members

Malaria is a major public health risk in Rwanda where children and pregnant women are most vulnerable. This infectious disease remains the main cause of morbidity and mortality among children in Rwanda. The main objectives of this study were to assess the prevalence of malaria among children aged six months to 14 years old in Rwanda and to identify the factors associated with malaria in this age group. This study used data from the 2017 Rwanda Malaria Indicator Survey. Due to the complex design used in sampling, a survey logistic regression model was used to fit the data and the outcome variable was the presence or absence of malaria. This study considered 8209 children in the analysis and the prevalence of malaria was 14.0%. This rate was higher among children aged 5–9 years old (15.6%), compared to other age groups. Evidently, the prevalence of malaria was also higher among children from poor families (19.4%) compared to children from the richest families (4.3%). The prevalence of malaria was higher among children from rural households (16.2%) compared to children from urban households (3.4%). The results revealed that other significant factors associated with malaria were: the gender of the child, the number of household members, whether the household had mosquito bed nets for sleeping, whether the dwelling had undergone indoor residual spraying in the 12 months prior to the survey, the location of the household’s source of drinking water, the main wall materials of the dwelling, and the age of the head of the household. The prevalence of malaria was also high among children living in houses with walls built from poorly suited materials; this suggests the need for intervention in construction materials. Further, it was found that the Eastern Province also needs special consideration in malaria control due to the higher prevalence of the disease among its residents, compared to those in other provinces.

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Diversity in antibody titer at an average of 87 days after the second dose of BNT162b2 mRNA coronavirus disease 2019 vaccine: data from a predominantly elderly population in a practice in Tokyo

10.1101/2021.12.22.21268296 ◽

2021 ◽

Author(s):

Yasuko Fuse-Nagase ◽

Mitsuo Nagase

Keyword(s):

Alcohol Consumption ◽

Antibody Titer ◽

High Mortality ◽

Elderly Population ◽

Vaccine Dose ◽

The Elderly ◽

Mortality Rates ◽

Negatively Associated ◽

Factors Associated ◽

Immunosuppressive Medication

It is very important for the elderly, who tend to have serious COVID-19 infection and high mortality rates, to maintain sufficient immunity. We reviewed the medical charts of predominantly elderly population to obtain the data on serum anti-SARS-CoV-2S antibody titer after complete vaccination with the BNT162b2 mRNA vaccine (two doses) and evaluated the background factors associated with the titer. We enrolled 230 participants (101 men and 129 women). Their average age was 71.9 (SD 12.5) years, and median was 72 years. The anti-SARS-CoV-2S antibody titer varied from 0.55 U/mL to 4920 U/mL. We found that the value of the titer varied widely. The value of the titer was negatively associated with age, alcohol consumption, time elapsed from second vaccine dose, and use of immunosuppressive medication. The result that the titer was negatively associated with aging suggests that the timing of additional shot should be carefully determined especially among elderly population.

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Antibiotics prescription and guidelines adherence in elderly: impact of the comorbidities

BMC Geriatrics ◽

10.1186/s12877-019-1265-1 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Anthony Dylis ◽

Anne Sophie Boureau ◽

Audrey Coutant ◽

Eric Batard ◽

François Javaudin ◽

...

Keyword(s):

Elderly Patients ◽

The Elderly ◽

Charlson Comorbidity Index Score ◽

Rehabilitation Services ◽

Multivariable Logistic Regression Analysis ◽

Negatively Associated ◽

Factors Associated ◽

Comorbidity Index ◽

Guidelines Adherence ◽

High Comorbidity

Abstract Background Although the interest of antibiotics is well known, antibiotics prescription is associated with side effect, especially in patients with multiples comorbidities. One way to reduce the incidence of side effects is to respect antibiotics prescriptions guidelines. Our objective was to investigated the factors associated with guidelines adherence in elderly patients with multiples comorbidities. Methods From October 2015 to December 2016, antibiotics prescription and guidelines adherence were analyzed in two post-acute care and rehabilitation services of a 2600-bed, university-affiliated center. Results One hundred and twenty-eight patients were included, fifty-nine (46%) patients had antibiotics prescription according to guidelines. In Multivariable logistic regression analysis, prescription of 2 antibiotics or more (OR = 0.168, 95% IC = 0.037–0.758, p < 0.05), 85 years of age and more (OR = 0.375, 95% IC = 0.151–0.931, p < 0.05) and the Charlson comorbidity index score (OR = 0.750, 95% IC = 0.572–0.984, p < 0.05) were negatively associated with antibiotics prescriptions according to guidelines. Conclusions High comorbidity in the elderly was negatively associated with the guidelines adherence of antibiotiсs prescriptions. These criteria should be considered to optimize antibiotics prescriptions in elderly patients.

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Factors associated with the hospitalization of the elderly: a national study

Revista Brasileira de Geriatria e Gerontologia ◽

10.1590/1981-22562018021.180059 ◽

2018 ◽

Vol 21 (4) ◽

pp. 439-446

Author(s):

Danielle Bordin ◽

Luciane Patrícia Andreani Cabral ◽

Cristina Berger Fadel ◽

Celso Bilynkievycz dos Santos ◽

Clóris Regina Blanski Grden

Keyword(s):

The Elderly ◽

Population Based ◽

National Health Survey ◽

Outcome Variable ◽

National Study ◽

Cross Sectional ◽

Factors Associated ◽

Medical Visits ◽

Care For The Elderly ◽

Health Related

Abstract Objective :to analyze the factors associated with hospitalization among the Brazilian elderly based on multidimensional methodology. Method: a cross-sectional, quantitative study was performed with data from the National Health Survey (2013) population-based study. The sample was composed of 23,815 individuals over the age of 60 years. Hospitalization was considered the outcome variable and 53 independent variables were included, relating to: sociodemographic characteristics; limitations and illness; difficulties in performing basic and instrumental activities of daily living; use of health services and medical emergencies. Results: it was found that 10% of the elderly were hospitalized in the previous year. This event was related to: a negative self-perception of health (OR = 1.35); stopping performing any of their usual activities due to health reasons (OR = 2.14); difficulty going to the doctor (OR = 1.65) or walking alone (OR = 1.55); a recent search for a site, service or health professional for health-related care (OR = 1.47); increased frequency of annual medical visits (OR = 2.93) and household emergency (OR = 5.40). Conclusion: the results reinforce the fact that multiple factors are associated with the hospitalization of the elderly. The analysis of these associations has the potential to make health professionals and administrators aware of the need to improve health care for the elderly and to assist in the organization and planning of the actions of the entire health service network.

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Epidemiology, vaccine effectiveness, and risk factors for mortality for pneumococcal disease among hospitalised adults in Singapore: a retrospective case-cohort study

10.21203/rs.2.13072/v2 ◽

2020 ◽

Author(s):

Tyson Chan ◽

Min Zhi Tay ◽

Win Mar Kyaw ◽

Angela Chow ◽

Hanley J Ho

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Pneumococcal Disease ◽

Multivariable Analysis ◽

Pneumococcal Vaccination ◽

Vaccine Effectiveness ◽

Retrospective Case ◽

Negatively Associated ◽

Factors Associated ◽

Icu Admission

Abstract Background: Streptococcus pneumoniae infections can lead to severe morbidity and mortality, especially in patients with invasive pneumococcal disease (IPD). This study evaluated factors associated with pneumococcal disease, pneumococcal vaccine effectiveness, and risk factors for mortality among hospitalised adults with pneumococcal disease in Singapore. Methods: Retrospective case-cohort study of patients tested for pneumococcal disease with streptococcal urinary antigen testing and at least one sterile site culture, during their admission to a tertiary hospital in Singapore from 2015-2017. Patients were defined as cases of IPD or non-IPD, or as controls, based on laboratory results and clinical diagnoses. Multivariable models were constructed to determine factors associated with IPD/non-IPD, and risk factors for mortality from pneumococcal disease. Vaccine effectiveness against IPD/non-IPD was estimated using a variation of the test-negative design. Results: We identified 496 pneumococcal disease cases, of whom 92 (18.5%) had IPD. The mean age of cases was 69.1±15.4yrs, and 65.5% were male. Compared with controls (N=9,181), IPD patients were younger (mean age 61.5±16.3yrs, vs 72.2±16.1yrs in controls; p<0.001) and with less co-morbidities [median Charlson’s score 1 (IQR 0-4), vs 3 (1-5) in controls; p<0.001]. IPD patients also had the highest proportions with intensive care unit (ICU) admission (20.7%), inpatient mortality (26.1%) and longest median length of stay [9 (IQR 8-17) days]. On multivariable analysis, IPD was negatively associated with prior pneumococcal vaccination (relative risk ratio=0.20, 95%CI 0.06–0.69; p=0.011). Risk factors for mortality among pneumococcal disease patients were ICU admission, diagnosis of IPD, age ≥85yrs and Charlson’s score >3.Conclusion: Patients with pneumococcal disease (especially IPD) were younger and had less co-morbidities than controls, but had higher risk of severe clinical outcomes and mortality. Pneumococcal vaccination was negatively associated with IPD and should be encouraged among high-risk patients.

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Risk factors associated with violence against elderly in a family setting

Temida ◽

10.2298/tem1803363r ◽

2018 ◽

Vol 21 (3) ◽

pp. 363-383

Author(s):

Katarina Risovic ◽

Silvia Rusac ◽

Natasa Todorovic

Keyword(s):

Risk Factors ◽

Scientific Community ◽

Elder Abuse ◽

Age Groups ◽

The Elderly ◽

Social Phenomenon ◽

Societal Factors ◽

Factors Associated ◽

The Family ◽

Family Setting

Violence as a social phenomenon does not know the age of a victim. It is happening at all stages of life and among members of all age groups. Ageing of the population and an increasing emphasis on its problems, among other things, raises the issue of violence against the elderly which is happening in their homes. Incorrect assumptions that violence occurs in institutions rather than in the family contributes to ignoring the problem. A combination of individual, relational, community, and societal factors contribute to the risk of becoming a victim and a perpetrator of elder abuse. Based on the so far research and knowledge, the paper aims to point out to the risk factor for elder abuse in order to sensitize and foster public and scientific community on activism, discovering and solving problems related to elder abuse in the family setting.

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Evaluation of Drug Utilisation Pattern and Clinical Presentation in Covid19 Patients Based on the Disease Severity

International Journal of Novel Trends in Pharmaceutical Sciences ◽

10.26452/ijntps.v11i2.1412 ◽

2021 ◽

Vol 11 (2) ◽

pp. 25-33

Author(s):

Kamsali Hema ◽

Peddoju Moulika ◽

Dinesh Kumar Kukunuri ◽

Ganta Saidhulu ◽

Dhivya K ◽

...

Keyword(s):

Clinical Features ◽

Communicable Disease ◽

Age Groups ◽

The Elderly ◽

Viral Disease ◽

Severe Illness ◽

Laboratory Findings ◽

Clinical Presentations ◽

Significant Difference ◽

Study Population

Coronavirus disease of 2019 (COVID-19) is an extremely communicable disease characterized by the serious acute respiratory influenza virus 2, a recently identified novel viral disease (SARS-CoV-2). Hitherto, the quantity of established instances worldwide has reached 135 million, and the number of deaths is 2.9 million. In India, the cases were found to be 20 million and the mortality rate is 3,51,000. This virus was first identified in Wuhan City, Hubei Province in China, at the end of 2019. Until now, it affected more than 200 countries. The treatment pattern and clinical presentations were assessed in COVID 19 patients. A total of 146 patients, severe patients (n = 71) and non-severe patients (n = 75) where included in the study. The mean age of the study population was found to be 58.76±14.32 and the most common symptoms of patients include fever, fatigue, dry cough, and diarrhea there is no statistically significant difference in the clinical features between severe and non-severe patients. There is no significant difference in the laboratory findings except lymphocyte count, CORADS and N/L ratio between severe and non-severe patients. COVID-19 affects all age groups especially the elderly. The risk for severe illness with COVID-19 increases with age. COVID 19 patients were presented with various the risk factors and the clinical features in the severe and non severe conditions patients, our study shows great significance to prevent the patient turning to critical condition during diagnosis and treatment.

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Factors associated with admission to bed-based care: observational prospective cohort study in a multidisciplinary same day emergency care unit (SDEC)

BMC Geriatrics ◽

10.1186/s12877-020-01942-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tania C. N. Elias ◽

Jordan Bowen ◽

Royah Hassanzadeh ◽

Daniel S. Lasserson ◽

Sarah T. Pendlebury

Keyword(s):

Hospital Admission ◽

Emergency Care ◽

Older Patients ◽

Age Groups ◽

Initial Assessment ◽

Severe Illness ◽

Ageing Population ◽

Care Needs ◽

Quality Healthcare ◽

Factors Associated

Abstract Background The development of ambulatory emergency care services, now called ‘Same Day Emergency Care’ (SDEC) has been advocated to provide sustainable high quality healthcare in an ageing population. However, there are few data on SDEC and the factors associated with successful ambulatory care in frail older people. We therefore undertook a prospective observational study to determine i) the clinical characteristics and frailty burden of a cohort in an SDEC designed around the needs of older patients and ii) the factors associated with hospital admission within 30-days after initial assessment. Methods The study setting was the multidisciplinary Abingdon Emergency Medical Unit (EMU) located in a community hospital and led by a senior interface physician (geriatrician or general practitioner). Consecutive patients from August–December 2015 were assessed using a structured paper proforma including cognitive/delirium screen, comorbidities, functional, social, and nutritional status. Physiologic parameters were recorded. Illness severity was quantified using the Systemic Inflammatory Response Syndrome (SIRS> 1). Factors associated with hospitalization within 30-days were determined using multivariable logistic regression. Results Among 533 patients (median (IQR) age = 81 (68–87), 315 (59%) female), 453 (86%) were living at home but 283 (54%) required some form of care and 299 (56%) had Barthel< 20. Falls, urinary incontinence and dementia affected 81/189 (43%), 50 (26%) and 40 (21%) of those aged > 85 years.” Severe illness was present in 148 (28%) with broadly similar rates across age groups. Overall, 210 (39%) patients had a hospital admission within 30-days with higher rates in older patients: 96 (87%) of < 65 years remained on an ambulatory pathway versus only 91 (48%) of ≥ 85 years (p < 0.0001). Factors independently associated with hospital admission were severe illness (SIRS/point, OR = 1.46,95% CI = 1.15–1.87, p = 0.002) and markers of frailty: delirium (OR = 11.28,3.07–41.44, p < 0.0001), increased care needs (OR = 3.08,1.55–6.12, p = 0.001), transport requirement (OR = 1.92,1.13–3.27), and poor nutrition (OR = 1.13–3.79, p = 0.02). Conclusions Even in an SDEC with a multidisciplinary approach, rates of hospital admission in those with severe illness and frailty were high. Further studies are required to understand the key components of hospital bed-based care that need to be replicated by models delivering acute frailty care closer to home, and the feasibility, cost-effectiveness and patient/carer acceptability of such models.

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