Department of Internal Medicine, National Cheng Kung University Hospital, Tainan 704, Taiwan.
Am J Emerg Med. 2013 May;31(5):783-7. doi: 10.1016/j.ajem.2013.01.011. Epub 2013 Feb 8.
The objective was to compare the clinical characteristics of elderly and young adult patients with dengue in the emergency department (ED).
Demographic characteristics, clinical presentation, disease severity, laboratory characteristics, and outcomes were analyzed prospectively as a case-control study.
Of the 193 adults with serologically confirmed dengue disease in 2007, 31 (16.1%) were elderly patients (aged ≥65) and 162 were young adults (aged <65). More dengue hemorrhagic fever (12.9% vs 2.5%, P = .02), a longer ED stay (13.3 vs 8.6 hours, P = .004), a longer hospital stay (7.4 vs 3.4 days, P < .001), a higher Simplified Acute Physiology Score II in the ED (29.7 vs 17.4, P < .001), and a higher rate of at least 1 comorbidity (61.8 vs 22.8%, P < .001) were found in the elderly. However, the length of the intensive care unit stay (elderly 0.7 vs young adults 0.3 day, P = .47) and the 14-day mortality rate (0% vs 0.6%, P = 1.00) were similar. Of note, in terms of clinical presentations of dengue in the ED, there were more elderly patients with isolated fever (41.9% vs 17.9%, P = .003) and fewer with typical presentation (41.9% vs 75.9%, P = <.001) than there were young adults.
The present study found a higher number of atypical presentations, a longer hospitalization, and a higher degree of clinical illness in elderly patients with dengue.
比较急诊科老年和成年登革热患者的临床特征。
前瞻性地进行病例对照研究，分析患者的人口统计学特征、临床表现、疾病严重程度、实验室特征和结局。
2007 年，193 例血清学确诊为登革热的成年人中，31 例（16.1%）为老年患者（年龄≥65 岁），162 例为成年患者（年龄<65 岁）。老年组中更常见登革出血热（12.9%比 2.5%，P=0.02）、更长的急诊停留时间（13.3 比 8.6 小时，P=0.004）、更长的住院时间（7.4 比 3.4 天，P<0.001）、更高的急诊简化急性生理学评分 II（29.7 比 17.4，P<0.001）和更高的至少一种合并症发生率（61.8%比 22.8%，P<0.001）。然而，老年组的重症监护病房停留时间（0.7 比年轻成年组 0.3 天，P=0.47）和 14 天死亡率（0%比 0.6%，P=1.00）相似。值得注意的是，在急诊科登革热的临床表现方面，老年患者中孤立发热的比例更高（41.9%比 17.9%，P=0.003），典型表现的比例更低（41.9%比 75.9%，P<0.001）。
本研究发现老年登革热患者表现更不典型、住院时间更长、临床病情更严重。
