Presentation of infection in older patients—a prospective study

Figures & data

Table I. Vital signs and other presenting signs and symptoms in older patients versus adults.

	All patients			Bacteremia			Microbiologically documented infection (MDI)
	Older patients	Adults	Difference	Older patients	Adults	Difference	Older patients	Adults	Difference
Parameter	Median (IQR)	Median (IQR)	P	Median (IQR)	Median (IQR)	P	Median (IQR)	Median (IQR)	P
Fever	38.3 (37.4–39.0)	38.4 (37.3–39.0)	0.08	38.7 (38.0–39.1)	38.7 (38.0–39.4)	0.458	38.5 (38.0–39.0)	38.5 (37.9–39.1)	0.843
HR	90.0 (80.0–109.0)	95.0 (78.0–100.0)	< 0.001	91.0 (80.0–106.0)	101.0 (89.5–116.0)	< 0.001	90.0 (80.0–103.0)	100.0 (86.0–110.7)	< 0.001
SBP	126.0 (108.0–145.0)	120.0 (105.0–138.0)	< 0.001	120.0 (100.0–138.0)	114.0 (98.0–137.0)	0. 288	122.5 (105.0–142.0)	117.0 (102.0–138.0)	0.012
DBP	67.0 (58.0–77.0)	70.0 (61.0–79.0)	< 0.001	63.0 (52.0–75.0)	64.0 (56.0–75.0)	0.191	65.5 (55.0–75.2)	67.0 (58.0–77.0)	0.047

Parameter	n (%)	n (%)	P	n (%)	n (%)	P	n (%)	n (%)	P
Consciousness	1029 (54.6)	1898 (85.2)	< 0.001	117 (50.9)	172 (77.5)	< 0.001	218 (45.6)	384 (78.5)	< 0.001
Dyspnea	608 (35.8)	462 (22.3)	< 0.001	58 (27.9)	40 (19.7)	0.052	127 (29.4)	101 (22.3)	0.016
Septic shock	81 (4.4)	59 (2.7)	0.03	25 (11.3)	10 (4.6)	0.01	39 (8.4)	19 (3.9)	0.004
Acute renal failure	388 (21.1)	241 (11.2)	< 0.001	86 (38.7)	41 (18.6)	< 0.001	141 (30.5)	82 (16.9)	< 0.001
Chills	257 (16.7)	458 (23.5)	< 0.001	68 (34.9)	73 (37.4)	0.598	100 (25.4)	141 (33.3)	0.014
Vomiting	177 (9.3)	292 (12.6)	0.01	21 (9.1)	35 (15.3)	0.041	46 (9.5)	65 (12.9)	0.091

DBP = diastolic blood pressure; HR = heart rate; IQR = interquartile range; SBP = systolic blood pressure.

Table II. Laboratory values in older patients versus adults.

	All patients			Bacteremia			Microbiologically documented infection (MDI)
	Older patients	Adults	Difference	Older patients	Adults	Difference	Older patients	Adults	Difference
Value	Median (IQR)	Median (IQR)	P	Median (IQR)	Median (IQR)	P	Median (IQR)	Median (IQR)	P
Leukocytes (×10^3/microL)	11.6 (8.3–15.7)	10.8 (7.5–15.0)	< 0.001	12.8 (8.7–18.0)	11.0 (7.9–15.5)	0.018	12.6 (8.8–16.9)	11.4 (7.8–15.5)	0.001
Creatinine (mg/dl)	1.1 (0.8–1.6)	0.9 (0.7–1.2)	< 0.001	1.3 (0.9–2.0)	1.0 (0.7–1.4)	< 0.001	1.2 (0.9–1.7)	0.9 (0.7–1.3)	< 0.001
Urea (mg/dl)	55.0 (39.0–85.0)	35.0 (24.0–54.0)	< 0.001	66.5 (47.0–105.3)	46.0 (29.0–70.0)	< 0.001	60.0 (43.0–98.0)	40.0 (27.0–66.0)	< 0.001
Glucose (mg/dl)	130.0 (108.0–177.0)	118.0 (99.0–157.0)	< 0.001	129. 0 (106. 0–176. 0)	123.0 (102.0–181.5)	0.533	130. 0 (107.0–181.0)	124.0 (102.0–176.0)	0.106
Sodium (mmol/L)	137.0 (133.0–140.0)	136.0 (133.0–139.0)	0.001	136.0 (132.0–138.5)	134.0 (132.0–138.0)	0.023	136.0 (133.0–139.0)	136.0 (133.0–138.0)	0.051
Platelets (×10^3/microL)	228.0 (167.5–310.0)	237.0 (176.0–315.0)	0.019	202.0 (144.8–267.0)	208.0 (137.0–287.0)	0.665	225.0 (167.0–307.0)	224.0 (157.3–299.8)	0.369

Table III. Main categories of final diagnosis.

	Older patients	Adults	Difference
Type of infection	n (%)	n (%)	P
All	1933 (100%)	2375 (100%)
Lower respiratory tract	454 (23.5%)	370 (15.6%)	< 0.001
Urinary tract	344 (17.8%)	260 (10.9%)	< 0.001
Abdominal	87 (4.5%)	191 (8.0%)	< 0.001
Soft tissue, bone	142 (7.3%)	209 (8.8%)	0.083
Upper respiratory	22 (1.1%)	36 (1.5%)	0.285
Endovascular	36 (1.9%)	38 (1.6%)	0.501
Neutropenic fever	32 (1.7%)	78 (3.8%)	0.001
Other bacterial	178 (9.2%)	233 (9.8%)	0.503
Non-bacterial infection	71 (3.7%)	163 (6.9%)	< 0.001
Indefinite	172 (8.9%)	216 (9.1%)	0.823
Unknown	212 (11%)	285 (12%)	0.291
Non-infectious	182 (9.4%)	238 (10%)	0.505
Missing	0 (0%)	42 (1.7%)	< 0.001