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Prospective cohort study of fever incidence and risk in elderly persons living at home.

ABSTRACT: To determine the incidence of fever among elderly persons under home medical management, diagnosis at fever onset and outcomes from a practical standpoint.Prospective cohort study.5 clinics in residential areas of Tokyo that process an average of 50-200?outpatients/day.Patients (n=419) aged ?65?years who received home medical management from the five clinics between 1 October 2009 and 30 September 2010.Fever (?37.5°C or ?1.5°C above usual body temperature), diagnosis at onset and outcomes (cure at home, hospitalisation and death).The incidence of fever was 2.5/1000 patient-days (95% CI 2.2 to 2.8). Fever occurred at least once (229 fever events) among one-third of the participants during the study period. Fever was more likely to arise in the wheelchair users or bedridden than in ambulatory individuals (HR 1.9 (95% CI 1.3 to 2.8; p<0.01); in patients with moderate-to-severe rather than those with none-to-mild cognitive impairment (HR, 1.7 (95% CI 1.1 to 2.6, p=0.01); and in those whose care-need levels were ?3 rather than ?2 (HR, 4.5 (95% CI 2.9 to 7.0; p<0.01). The causes of fever were pneumonia/bronchitis (n=103), skin and soft tissue infection (n=26), urinary tract infection (n=22) and the common cold (n=13). Fever was cured in 67% and 23% of patients at home and in hospital, respectively, and 5% of patients each died at home and in hospital. Antimicrobial agents treated 153 (67%) events in the home medical care setting.Fever was more likely to occur in those requiring higher care levels and the main cause of fever was pneumonia/bronchitis. Healthcare providers should consider the conditions of elderly residents with lower objective functional status.

SUBMITTER: Yokobayashi K

PROVIDER: S-EPMC4091458 | biostudies-literature | 2014

REPOSITORIES: biostudies-literature

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Prospective cohort study of fever incidence and risk in elderly persons living at home.

Yokobayashi Kenichi K Matsushima Masato M Watanabe Takamasa T Fujinuma Yasuki Y Tazuma Susumu S

BMJ open 20140709 7

<h4>Objective</h4>To determine the incidence of fever among elderly persons under home medical management, diagnosis at fever onset and outcomes from a practical standpoint.<h4>Design</h4>Prospective cohort study.<h4>Setting</h4>5 clinics in residential areas of Tokyo that process an average of 50-200 outpatients/day.<h4>Participants</h4>Patients (n=419) aged ≥65 years who received home medical management from the five clinics between 1 October 2009 and 30 September 2010.<h4>Main outcome measure ...[more]

PMID: 25009132

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Dataset Information

Prospective cohort study of fever incidence and risk in elderly persons living at home.

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Prospective cohort study of fever incidence and risk in elderly persons living at home.

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