Patient Factors and Hospital Outcomes Associated With Atypical Presentation in Hospitalized Older Adults With COVID-19 During the First Surge of the Pandemic.
Patient Factors and Hospital Outcomes Associated With Atypical Presentation in Hospitalized Older Adults With COVID-19 During the First Surge of the Pandemic.
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大流行期间，在住院的老年人中，与非典型老年人相关的患者因素和医院结果与非典型的表现有关。
DOI：
10.1093/gerona/glab171
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发表时间：
2022-04-01
期刊：
影响因子：
--
通讯作者：
Sinvani L
中科院分区：
文献类型：
--
作者：
Marziliano A;Burns E;Chauhan L;Liu Y;Makhnevich A;Zhang M;Carney MT;Dbeis Y;Lindvall C;Qiu M;Diefenbach MA;Sinvani L
文献表明COVID-19在老年人（OAs）中的非典型表现。我们的目的是确定非典型表现的频率，并比较人口统计学和临床因素，以及在第一次大流行期间因COVID-19住院的OAs的典型与非典型表现之间的短期结局。从住院电子健康记录中提取的数据是针对2020年3月1日至4月20日期间因COVID-19入住我们卫生系统医院的65岁及以上患者。由OA或其代表报告的表现由入院专业人员记录，包括症状和体征。使用自然语言处理来编码每个症状或体征的存在/不存在。典型表现定义为表示发热、咳嗽或呼吸急促的词语;非典型表现定义为表示功能下降或精神状态改变的词语。在4961例OAs中，以功能下降或精神状态改变为特征的不典型表现分别占24.9%和11.3%。非典型表现与年龄较大、女性、黑人、非西班牙裔、合并症指数较高以及存在痴呆和糖尿病相关。那些表现典型的人比那些表现不典型的人接受重症监护室级别护理的可能性高1.39倍。典型与非典型OAs患者的死亡率、住院时间和30天再入院率的医院结局相似。虽然OAs的非典型表现与呼吸窘迫的急性干预需求无关，但不能忽视它。
Literature indicates an atypical presentation of COVID-19 among older adults (OAs). Our purpose is to identify the frequency of atypical presentation and compare demographic and clinical factors, and short-term outcomes, between typical versus atypical presentations in OAs hospitalized with COVID-19 during the first surge of the pandemic. Data from the inpatient electronic health record were extracted for patients aged 65 and older, admitted to our health systems’ hospitals with COVID-19 between March 1 and April 20, 2020. Presentation as reported by the OA or his/her representative is documented by the admitting professional and includes both symptoms and signs. Natural language processing was used to code the presence/absence of each symptom or sign. Typical presentation was defined as words indicating fever, cough, or shortness of breath; atypical presentation was defined as words indicating functional decline or altered mental status. Of 4 961 unique OAs, atypical presentation characterized by functional decline or altered mental status was present in 24.9% and 11.3%, respectively. Atypical presentation was associated with older age, female gender, Black race, non-Hispanic ethnicity, higher comorbidity index, and the presence of dementia and diabetes mellitus. Those who presented typically were 1.39 times more likely than those who presented atypically to receive intensive care unit–level care. Hospital outcomes of mortality, length of stay, and 30-day readmission were similar between OAs with typical versus atypical presentations. Although atypical presentation in OAs is not associated with the same need for acute intervention as respiratory distress, it must not be dismissed.
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DOI：
10.1016/s2215-0366(20)30434-x
发表时间：
2020-12
期刊：
The lancet. Psychiatry
影响因子：
--
作者：
Livingston G;Rostamipour H;Gallagher P;Kalafatis C;Shastri A;Huzzey L;Liu K;Sommerlad A;Marston L
通讯作者：
Marston L
影响因子：
4
作者：
Li, Tao;Lu, Lei;Duan, Jun
通讯作者：
Duan, Jun
影响因子：
12.7
作者：
Andrade, Justin A.;Muzykovsky, Karina;Truong, James
通讯作者：
Truong, James
影响因子：
2.1
作者：
Gan JM;Kho J;Akhunbay-Fudge M;Choo HM;Wright M;Batt F;Mandal AKJ;Chauhan R;Missouris CG
通讯作者：
Missouris CG
影响因子：
6.3
作者：
D'Adamo, Heather;Yoshikawa, Thomas;Ouslander, Joseph G.
通讯作者：
Ouslander, Joseph G.