Hypotension, bedridden, leukocytosis, thrombocytopenia and elevated serum creatinine predict mortality in geriatric patients with fever.

The geriatric population (aged ≥65 years) accounts for 12–24% of all emergency department (ED) visits. Of them, 10% have a fever, 70–90% will be admitted and 7–10% of will die within a month. Therefore, mortality prediction and appropriate disposition after ED treatment are of great concern for geri...

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Publicado en:Geriatrics & Gerontology International Vol. 15; no. 7; pp. 834 - 840
Autores principales: Min-Hsien Chung, Feng-Yuan Chu, Tzu-Meng Yang, Hung-Jung Lin, Jiann-Hwa Chen, How-Ran Guo, Si-Chon Vong, Shih-Bin Su, Chien-Cheng Huang, Chien-Chin Hsu
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Jul2015
Acceso en línea:Ver este registro en EBSCOhost
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        10.1111/ggi.12355
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        atl: Hypotension, bedridden, leukocytosis, thrombocytopenia and elevated serum creatinine predict mortality in geriatric patients with fever.
      aug:
        au:
          Min-Hsien Chung
          Feng-Yuan Chu
          Tzu-Meng Yang
          Hung-Jung Lin
          Jiann-Hwa Chen
          How-Ran Guo
          Si-Chon Vong
          Shih-Bin Su
          Chien-Cheng Huang
          Chien-Chin Hsu
        affil: Department of Emergency Medicine, Chi-Mei Medical Center, Tainan.
      sug:
        subj:
          Hypotension
          Leukocyte Disorders
          Thrombocytopenia
          Creatinine Blood
          Fever In Old Age
          Hospital Mortality
          Hospitalization of Older Persons
          Human
          Male
          Female
          Emergency Service
          Sensitivity and Specificity
          Predictive Value of Tests
          Aged
          Aged: 65+ years
          Male
          Female
      ab: The geriatric population (aged ≥65 years) accounts for 12–24% of all emergency department (ED) visits. Of them, 10% have a fever, 70–90% will be admitted and 7–10% of will die within a month. Therefore, mortality prediction and appropriate disposition after ED treatment are of great concern for geriatric patients with fever. We tried to identify independent mortality predictors of geriatric patients with fever, and combine these predictors to predict their mortality. Methods: We enrolled consecutive geriatric patients visiting the ED between 1 June and 21 July 2010 with the following criteria of fever: a tympanic temperature ≥37.2°C or a baseline temperature elevated ≥1.3°C. We used 30-day mortality as the primary end-point. Results: A total of 330 patients were enrolled. Hypotension, bedridden, leukocytosis, thrombocytopenia and serum creatinine >2 mg/dL, but not age, were independently associated with 30-day mortality. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) ranged from 18.2% to 90.9%, 34.7% to 100%, 9.0% to 100% and 94.5% to 98.2%, respectively, depending on how many predictors there were. Conclusions: The 30-day mortality increased with the number of independent mortality predictors. With at least four predictors, 100% of the patients died within 30 days. With none of the predictors, just 1.8% died. These findings might help physicians make decisions about geriatric patients with fever.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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