Nosocomial febrile illness in the elderly: frequency, causes, and risk factors.
Arch Intern Med
; 158(14): 1560-5, 1998 Jul 27.
Article
em En
| MEDLINE
| ID: mdl-9679797
ABSTRACT
BACKGROUND:
Although nosocomial febrile illness (NFI) is common in hospitalized patients, it has been less extensively studied in the elderly.OBJECTIVE:
To determine the frequency, causes, and risk factors of NFI in elderly inpatients.METHODS:
This prospective study involved 608 patients (> or = 65 years of age) admitted in an acute geriatric unit. Investigators followed this cohort until 1 of the following events occurred development of NFI, discharge from the geriatric unit, or death. The cause of NFI was classified into 3 groups infectious, noninfectious, and no apparent diagnosis. We systematically studied 17 comorbid conditions, 6 drugs, and 7 invasive procedures. For comparison, the patients were stratified into 2 groups patients with NFI and patients without NFI.RESULTS:
Sixty-six patients (10.9%) with NFI were identified. They were compared with the remaining 542 patients without NFI. In 49 patients (74%) with NFI, the cause was infectious; in 9 (13.5%), it was noninfectious; and in 8 (12.5%), there was no apparent cause. After multivariate analysis, only fecal incontinence (odds ratio [OR], 5.54; 95% confidence interval [CI], 2.13-14.5), congestive heart failure (OR, 2.97; 95% CI, 1.53-5.76), and pressure ulcers (OR, 2.93; 95% CI, 1.19-7.17) were independent risk factors for NFI. The number of invasive procedures preceding the febrile episode was a significant predictor of infection (OR, 3.68; 95% CI, 1.14-9.21).CONCLUSIONS:
Nosocomial febrile illness is a common event in elderly hospitalized patients. In 74% of the patients with NFI, an infection is found. Measures to decrease infectious NFI in the elderly require a reduction in the number of invasive procedures.
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Base de dados:
MEDLINE
Assunto principal:
Infecção Hospitalar
/
Febre
/
Hospitalização
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
País/Região como assunto:
Europa
Idioma:
En
Ano de publicação:
1998
Tipo de documento:
Article