Infectious Disease-Related Emergency Department Visits of Elderly Adults in the United States, 2011-2012
Infectious Disease-Related Emergency Department Visits of Elderly Adults in the United States, 2011-2012
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DOI：
10.1111/jgs.13836
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发表时间：
2016-01-01
影响因子：
6.3
通讯作者：
Hasegawa, Kohei
中科院分区：
文献类型：
--
作者：
Goto, Tadahiro;Yoshida, Kazuki;Hasegawa, Kohei
目的：调查美国老年人与传染病（ID）相关的急诊（艾德）就诊频率。设计：横断面分析。设置：2011- 12年全国急诊样本。参与者：艾德年龄65岁及以上的主要诊断为ID的个体。测量：与ID相关的艾德就诊、住院、基于医院的死亡率。结果：2012年期间，在美国老年人中计算了3，123，909例艾德ID访视的加权估计值。这占老年人所有艾德就诊的13.5%（310万次就诊）;这一负担高于心肌梗死和充血性心力衰竭的总和。与身份证相关的艾德就诊率为每10万名老年人中有7,231人。最常见的诊断为下呼吸道感染（26.2%; 95%置信区间（CI）= 25.7-26.6%）、尿路感染（25.3%，95% CI = 25.0-25.7%）和败血症（18.9%，95% CI = 18.3-19.6%）。在所有ID相关艾德访视中，1，786，657例（57.2%，95% CI = 56.6-57.7%）导致住院。住院的主要原因是败血症，占所有ID相关住院的32.2%（95% CI = 31.1-33.3%），其次是下呼吸道感染（27.8%，95% CI = 27.2-28.4%）。总体而言，123，894例患者（4.0%，95% CI = 3.8-4.1%）在艾德访视或住院期间死亡。其中，败血症是死亡的主要原因（74.7%，95% CI = 73.8-75.6%），其次是下呼吸道感染（15.2%，95% CI = 14.6-15.9%）。2011年的数据分析了类似的结果，为负担ID相关的艾德访问，住院，和mortals.CONCLUSION：使用一个全国代表性的样本，它被发现，公共卫生负担的ID在老年美国成年人是巨大的，作为衡量艾德访问，随后住院，和医院为基础的死亡率。
OBJECTIVES: To investigate the frequency of infectious disease (ID)-related emergency department (ED) visits of elderly adults in the United States.DESIGN: Cross-sectional analysis.SETTING: Nationwide emergency department sample in 2011-12.PARTICIPANTS: Individuals in the ED aged 65 and older with a primary diagnosis of an ID.MEASUREMENTS: ID-related ED visits, hospitalizations, hospital-based mortality.RESULTS: During 2012, a weighted estimate of 3,123,909 ED visits for IDs was calculated in elderly U.S. adults. This accounted for 13.5% (3.1 million visits) of all ED visits of elderly adults; this burden was higher than that for myocardial infarction and congestive heart failure combined. The rate of ID-related ED visits was 7,231 per 100,000 elderly adults. The most-common diagnoses were lower respiratory infections (26.2%; 95% confidence interval (CI) = 25.7-26.6%), urinary tract infections (25.3%, 95% CI = 25.0-25.7%), and septicemia (18.9%, 95% CI = 18.3-19.6%). Of all ID-related ED visits, 1,786,657 (57.2%, 95% CI = 56.6-57.7%) resulted in hospitalization. The leading cause of hospitalization was septicemia, accounting for 32.2% (95% CI = 31.1-33.3%) of all ID-related hospitalizations through EDs, followed by lower respiratory infections (27.8%, 95% CI = 27.2-28.4%). Overall, 123,894 individuals (4.0%, 95% CI = 3.8-4.1%) died during their ED visit or hospitalization. Of these, septicemia was the leading cause of mortality (74.7%, 95% CI = 73.8-75.6%), followed by lower respiratory infections (15.2%, 95% CI = 14.6-15.9%). Analysis of the 2011 data gave similar results for the burden of ID-related ED visits, hospitalizations, and mortality.CONCLUSION: Using a nationally representative sample, it was found that the public health burden of IDs in elderly U.S. adults was substantial, as measured by ED visits, subsequent hospitalizations, and hospital-based mortality.