Is age associated with different vital signs in adults presenting to hospital with bacterial infection? A systematic review and meta-analysis.

Background It has long been suspected that the vital sign abnormalities that accompany bacterial infection are subtle or absent in older adults. This review summarises the evidence for whether older adults present with different vital sign abnormalities to younger adults when hospitalised with bacte...

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Publicado en:Age & Ageing Vol. 54; no. 7; pp. 1 - 11
Autores principales: Tupper, Phoebe, Redfern, Oliver, Harrison, Charlotte H, Gerry, Stephen, Biggs, Christopher, Walker, Bethany, Watkinson, Peter
Formato: Artículo
Publicado: Oxford University Press / USA Jul2025
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Acceso en línea:Ver este registro en EBSCOhost
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        atl: Is age associated with different vital signs in adults presenting to hospital with bacterial infection? A systematic review and meta-analysis.
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        au:
          Tupper, Phoebe
          Redfern, Oliver
          Harrison, Charlotte H
          Gerry, Stephen
          Biggs, Christopher
          Walker, Bethany
          Watkinson, Peter
        affil:
          Critical Care Research Group, Kadoorie Centre for Critical Care Research and Education, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
          Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
          Oxford Critical Care, Oxford University Hospitals NHS Trust, Oxford, UK
          Oxford Biomedical Research Centre, National Institute for Health and Care Research (NIHR), Oxford, Oxfordshire, UK
      su:
        Patients
        Hospital care
        Hospital admission & discharge
        Age distribution
        Adults
        Old age
        Vital signs
        Medical information storage & retrieval systems
        Research funding
        CINAHL database
        Meta-analysis
        Fever
        Descriptive statistics
        Relative medical risk
        Systematic reviews
        MEDLINE
        Heart beat
        Bacterial diseases
        Tachycardia
        Symptoms
      sug:
        subj:
          Patients
          Hospital care
          Hospital admission & discharge
          Age distribution
          Adults
          Old age
          Vital signs
          Medical information storage & retrieval systems
          Research funding
          CINAHL database
          Meta-analysis
          Fever
          Descriptive statistics
          Relative medical risk
          Systematic reviews
          MEDLINE
          Heart beat
          Bacterial diseases
          Tachycardia
          Symptoms
      keyword:
        age
        diagnosis
        infection
        older people
        systematic review
        vital signs
        age
        diagnosis
        infection
        older people
        systematic review
        vital signs
      ab: Background It has long been suspected that the vital sign abnormalities that accompany bacterial infection are subtle or absent in older adults. This review summarises the evidence for whether older adults present with different vital sign abnormalities to younger adults when hospitalised with bacterial infection. Methods MEDLINE, EMBASE and CINAHL EBSCO were searched from inception to 19 December 2024 for English-language research articles of patients hospitalised with bacterial infection reporting age and admission vital signs. We used meta-regression to assess how vital signs vary with age. Where studies reported vital signs in multiple age groups, we undertook a meta-analysis in younger (<65) and older patients (≥65). Evidence quality was assessed using an adapted Quality Assessment of Diagnostic Accuracy Studies-2 tool. Results Our search yielded 14 487 studies; 132 were included after screening. Older adults were less likely to be tachycardic (RR 0.82, 0.69 to 0.97, I  = 86.5%) with a mean difference in heart rate of 5 bpm (−7 to −3 bpm, I  = 88.3%). Older adults were less likely to be febrile (RR 0.89, 0.83 to 0.95, I  = 85.9%) with a mean difference in temperature of 0.14°C (−0.26 to −0.02°C, I  = 94.6%). Most (129/132) studies were at high risk of bias. Conclusions Whilst differences in absolute values were small, there was consistency in the finding that older adults were less likely than younger adults to be tachycardic or febrile. As vital signs at presentation may prompt suspicion of infection, influencing investigations and treatment, special consideration for the possibility of infection in older patients with normal vital signs may be warranted.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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