Risk factors for the development of bacteremia in nursing home patients

1995 ◽  
Vol 4 (9) ◽  
pp. 785-789 ◽  
Author(s):  
J. P. Richardson
Keyword(s):  
Risk Factors ◽  
Nursing Home ◽  
Nursing Home Patients

scholarly journals Risk Factors for In-Hospital Mortality from COVID-19 Among Nursing Home Patients—An Urban Center Experience

2021 ◽  
Vol 1 (S1) ◽  
pp. s48-s48
Author(s):  
Amit Vahia ◽  
Mamta Sharma ◽  
Leonard Johnson ◽  
Ashish Bhargava ◽  
Louis Saravolatz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Logistic Regression ◽  
Nursing Home ◽  
Hospital Mortality ◽  
Multivariable Analysis ◽  
Case Fatality ◽  
Severe Infection ◽  
Robust Immune Response ◽  
Risk Of Death ◽  
Nursing Home Patients

Background: As the COVID-19 pandemic continues, special attention is focused on high-risk patients. In this study, we assessed the risk factors for COVID-19 mortality in nursing home patients. Methods: In this retrospective cohort study, we reviewed the electronic medical records of SARS-COV-2 PCR–positive nursing-home patients between March 8 and June 14, 2020. The primary outcome was in-hospital mortality. Risk factors were compared between those who were discharged or died using the Student t test, the Mann-Whitney U test, χ2 analysis, and logistic regression. Results: Among 169 hospitalized nursing-home patients, the case fatality rate was 43.2%. The mean age was 72.3 ± 13.8 years; 92 patients (54.4%) were male; and 112 patients (66.3%) were black. Within the first day of hospitalization, 83 (49%) patients developed fever. On admission, 24 (14.2%) patients were hypotensive. Leukopenia, lymphopenia, and thrombocytopenia were present in 20 (12%), 91 (53%), and 40 (23.7%) patients, respectively. Among the inflammatory markers, elevations in CRP and ferritin levels occurred in 79% and 24%, respectively. Intensive care admission was needed for 40 patients (23.7%). Septic shock occurred in 25 patients (14.8%). Patients over the age of 70 were more likely to die than younger patients (OR, 2.2; 95% CI, 1.2– 4.1; P = .20). Patients with a fever on admission were more likely to die than those who were afebrile (OR, 2.03; 95% CI, 1.08–3.8; P = .03). Also, 66.7% hypotensive patients died compared to 39.3% normotensive patients (OR, 3.1; 95% CI, 1.2–7.7 P = .01). Intubated patients died more often than those not intubated, 78.4% versus 33.3%, respectively (OR=7.3, p < 0.001, CI 3.1, 17.2) Factors significantly associated with death included higher mean qSofa (p < 0.001), higher median Charlson scores (0.02), thrombocytopenia (p = 0.04) and lymphocytopenia (0.04). From multivariable logistic regression, independent factors associated with death were Charlson score (OR=1.2, p=0.05), qSofa (OR=2.0, p=0.004), thrombocytopenia (OR = 3.0, p = 0.01) and BMI less than 25 (OR = 3.5, p=0.002). Conclusions: Our multivariable analysis revealed that patients with a greater burden of comorbidities, lower BMI, higher qSOFA sepsis score, and thrombocytopenia had a higher risk of death, perhaps because of severe infection despite a robust immune response.Funding: NoDisclosures: None

Nursing home patients in the intensive care unit: Risk factors for mortality

2006 ◽  
Vol 34 (10) ◽  
pp. 2583-2587 ◽  
Author(s):  
Melissa L. P. Mattison ◽  
James L. Rudolph ◽  
Dan K. Kiely ◽  
Edward R. Marcantonio
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Nursing Home ◽  
Unit Risk ◽  
Nursing Home Patients

scholarly journals Palliative care for nursing home patients with dementia: service evaluation and risk factors of mortality

2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Chih-Pang Chu ◽  
Cho-Yin Huang ◽  
Chian-Jue Kuo ◽  
Ying-Yeh Chen ◽  
Chun-Tse Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Palliative Care ◽  
Nursing Home ◽  
Service Evaluation ◽  
Nursing Home Patients

scholarly journals Pneumococcal Pneumonia and Invasive Pneumococcal Disease in Those 65 and Older: Rates of Detection, Risk Factors, Vaccine Effectiveness, Hospitalisation and Mortality

Geriatrics ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 13
Author(s):  
Roger E. Thomas
Keyword(s):  
Risk Factors ◽  
Nursing Home ◽  
Invasive Pneumococcal Disease ◽  
Disease Transmission ◽  
Pneumococcal Disease ◽  
Pneumococcal Pneumonia ◽  
Clinical Symptoms ◽  
Disease Incidence ◽  
Family Members ◽  
Vaccination Rates

Pneumococcal pneumonia (PP) and invasive pneumococcal disease (IPD) are important causes of morbidity and mortality in seniors worldwide. Incidence rates and serious outcomes worsen with increasing frailty, numbers of risk factors and decreasing immune competence with increasing age. Literature reviews in Medline and Embase were performed for pneumococcal disease incidence, risk factors, vaccination rates and effectiveness in the elderly. The introduction of protein-conjugated pneumoccal vaccines (PCV) for children markedly reduced IPD and PP in seniors, but serotypes not included in vaccines and with previously low levels increased. Pneumococcal polysaccharide (PPV23) vaccination does not change nasal and pharyngeal carriage rates. Pneumococcal and influenza vaccination rates in seniors are below guideline levels, especially in older seniors and nursing home staff. Pneumococcal and influenza carriage and vaccination rates of family members, nursing home health care workers and other contacts are unknown. National vaccination programmes are effective in increasing vaccination rates. Detection of IPD and PP initially depend on clinical symptoms and new chest X ray infiltrates and then varies according to the population and laboratory tests used. To understand how seniors and especially older seniors acquire PP and IPD data are needed on pneumococcal disease and carriage rates in family members, carers and contacts. Nursing homes need reconfiguring into small units with air ventilation externally from all rooms to minimise respiratory disease transmission and dedicated staff for each unit to minimise transmision of infectious diseaases.

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