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Should clinical case definitions of influenza in hospitalized older adults include fever?

Falsey AR, Baran A, Walsh EE - Influenza Other Respir Viruses (2015)

Bottom Line: The highest temperature reported prior to admission or measured during the first 24 h after admission was recorded.The commonly used definition of ILI (fever ≥ 37·8°C and cough) resulted in 57% sensitivity and 71% specificity in older adults.Receiver operating characteristic curves examining the various temperature thresholds combined with cough and/or sore throat showed the optimal balance between sensitivity and specificity to be 37·9°C (AUC 0·71) and 37·3°C (AUC 0·66), in younger and older persons, respectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, University of Rochester, Rochester, NY, USA.

No MeSH data available.


Related in: MedlinePlus

Clinical features of influenza in young and elderly subjects with documented influenza. Bars indicate the percentage of subjects with the findings: black bars, subjects ≥65 years of age; white bars, subjects <65 years of age.
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fig02: Clinical features of influenza in young and elderly subjects with documented influenza. Bars indicate the percentage of subjects with the findings: black bars, subjects ≥65 years of age; white bars, subjects <65 years of age.

Mentions: The presenting signs and symptoms of subjects younger and older than 65 years of age were compared and demonstrated several significant differences (Figure2). Older subjects less commonly complained of systemic symptoms (myalgias, fatigue, and feverishness) and more often had abnormal lung examinations than did younger subjects. However, the mean highest recorded temperature was identical in both groups (38·1°C) and the percentage of subjects with documented temperature of at least 37·8°C in the two groups were not significantly different. Older patients also had significantly lower oxygen saturation (88·9 ± 6·7% versus 91·0 ± 7·0%) and presented to the hospital earlier (5·0 ± 5·9 versus 7·0 ± 4·2 days) than did younger individuals. Of note, documented bacterial complications were similar in younger and older patients.


Should clinical case definitions of influenza in hospitalized older adults include fever?

Falsey AR, Baran A, Walsh EE - Influenza Other Respir Viruses (2015)

Clinical features of influenza in young and elderly subjects with documented influenza. Bars indicate the percentage of subjects with the findings: black bars, subjects ≥65 years of age; white bars, subjects <65 years of age.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4549099&req=5

fig02: Clinical features of influenza in young and elderly subjects with documented influenza. Bars indicate the percentage of subjects with the findings: black bars, subjects ≥65 years of age; white bars, subjects <65 years of age.
Mentions: The presenting signs and symptoms of subjects younger and older than 65 years of age were compared and demonstrated several significant differences (Figure2). Older subjects less commonly complained of systemic symptoms (myalgias, fatigue, and feverishness) and more often had abnormal lung examinations than did younger subjects. However, the mean highest recorded temperature was identical in both groups (38·1°C) and the percentage of subjects with documented temperature of at least 37·8°C in the two groups were not significantly different. Older patients also had significantly lower oxygen saturation (88·9 ± 6·7% versus 91·0 ± 7·0%) and presented to the hospital earlier (5·0 ± 5·9 versus 7·0 ± 4·2 days) than did younger individuals. Of note, documented bacterial complications were similar in younger and older patients.

Bottom Line: The highest temperature reported prior to admission or measured during the first 24 h after admission was recorded.The commonly used definition of ILI (fever ≥ 37·8°C and cough) resulted in 57% sensitivity and 71% specificity in older adults.Receiver operating characteristic curves examining the various temperature thresholds combined with cough and/or sore throat showed the optimal balance between sensitivity and specificity to be 37·9°C (AUC 0·71) and 37·3°C (AUC 0·66), in younger and older persons, respectively.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, University of Rochester, Rochester, NY, USA.

No MeSH data available.


Related in: MedlinePlus