Risk factors for lower respiratory complications of rhinovirus infections in elderly people living in the community: Prospective cohort study
Risk factors for lower respiratory complications of rhinovirus infections in elderly people living in the community: Prospective cohort study
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DOI：
10.1136/bmj.313.7065.1119
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发表时间：
1996-11-02
影响因子：
105.7
通讯作者：
Cancio, E
中科院分区：
文献类型：
--
作者：
Nicholson, KG;Kent, J;Cancio, E
目的：评估鼻病毒在社区老年人中的作用。设计：以社区为基础的前瞻性监测，无干预。每周给受试者打电话，以确定有症状的上呼吸道感染。监测疾病的症状和影响，并收集样本进行诊断血清学和人类鼻病毒聚合酶链式反应。背景-英国莱斯特郡。受试者-533名年龄在60岁到90岁之间的受试者。96例鼻病毒感染期间的主要观察指标-症状、活动限制、就诊和抗生素使用。调整了下呼吸道综合征与吸烟和健康状况的优势比。结果：在497例呼吸道疾病中，211例(43%)被确定为病毒原因；121例(24%)被确定为鼻病毒，107例被确定为单一病原体。在患有107例鼻病毒感染的96人中，首次或唯一鼻病毒感染的中位持续时间为16天；96名患者中有18人卧床休息，25人无法应对日常家庭活动。总体而言，60名鼻病毒感染患者有下呼吸道综合征；41名患者咨询了他们的医生，其中31人(76%)接受了抗生素治疗。一名患者死亡。Logistic回归分析显示，慢性疾病使下呼吸道鼻病毒疾病的估计概率增加了40%(95%可信区间为17%至68%)，吸烟增加了47%(14%至90%)。有症状的鼻病毒感染几乎是甲型和乙型流感感染的6倍。结论鼻病毒是社区老年人虚弱和下呼吸道疾病的重要原因。慢性健康状况不佳和吸烟增加了此类感染引起下呼吸道并发症的可能性。老年人鼻病毒感染的总体负担可能接近流感。
Objective-To assess the role of rhinoviruses in elderly people living in the community.Design-Prospective community based surveillance of elderly people, without intervention. Subjects were telephoned weekly to identify symptomatic upper respiratory tract infections. Symptoms and impact of illnesses were monitored, and specimens were collected for diagnostic serology and human rhinovirus polymerase chain reaction.Setting-Leicestershire, England.Subjects-533 subjects aged 60 to 90.Main outcome measures-Symptoms, restriction of activity, medical consultations, and antibiotic use during 96 rhinovirus infections. Adjusted odds ratios for lower respiratory syndromes with respect to smoking and health status.Results-A viral cause was established in 211 (43%) of 497 respiratory illnesses; rhinoviruses were identified in 121 (24%) and as single pathogens in 107. The median duration of the first or only rhinovirus infection in the 96 people with 107 rhinovirus infections was 16 days; 18 of the 96 patients were confined to bed and 25 were unable to cope with routine household activities. Overall, 60 patients with rhinovirus infections had lower respiratory tract syndromes; 41 patients consulted their doctor, 31 of them (76%) receiving antibiotics. One patient died. Logistic regression analysis showed that chronic medical conditions increased the estimated probability of lower respiratory rhinovirus illness by 40% (95% confidence interval 17% to 68%) and smoking by 47% (14% to 90%). There were almost six times as many symptomatic rhinovirus infections as influenza A and B infections.Conclusions-Rhinoviruses are an important cause of debility and lower respiratory illness among elderly people in the community. Chronic ill health and smoking increase the likelihood of lower respiratory complications from such infections. The overall burden of rhinovirus infections in elderly people may approach that of influenza.