標題: Characteristics of scrub typhus, murine typhus, and Q fever among elderly patients: Prolonged prothrombin time as a predictor for severity
作者: Chang, Ko
Lee, Nan-Yao
Ko, Wen-Chien
Lin, Wei-Ru
Chen, Yen-Hsu
Tsai, Jih-Jin
Chen, Tun-Chieh
Lin, Chun-Yu
Chang, Ya-Ting
Lu, Po-Liang
生醫工程研究所
Institute of Biomedical Engineering
關鍵字: Elderly;Scrub typhus;Acute Q fever;Murine typhus;Complications
公開日期: 1-Feb-2019
摘要: Background/purpose: The clinical manifestations of scrub typhus, murine typhus and acute Q fever in the elderly are not clear. Methods: We conducted a retrospective study to identify the characteristics of the elderly aged >= 65 years with a comparison group aged 18-64 years among patients with scrub typhus, murine typhus, or acute Q fever who were serologically confirmed at three hospitals in Taiwan during 2002-2011. Results: Among 441 cases, including 187 cases of scrub typhus, 166 acute Qfever, and 88 murine typhus, 68 (15.4%) cases were elderly patients. The elderly had a higher severe complication rate (10.3% vs. 3.5%, p = 0.022), but did not have a significantly higher mortality rate (1.47% vs. 0.54%, p = 0.396). Compared with those without severe complications, we found the elderly (p = 0.022), dyspnea (p = 0.006), less relative bradycardia (p = 0.004), less febrile illness (p = 0.004), prolonged prothrombin time (PT) (p = 0.002), higher levels of initial C-reactive protein (p = 0.039), blood leukocyte counts (p = 0.01), and lower platelet counts (p = 0.012) are significantly associated with severe complications. Only prolonged prothrombin time was associated with severe complications in multivariate analysis (p = 0.018, CI 95% 0.01-0.66). Among clinical symptoms and laboratory data, multivariate analysis revealed chills was less frequently occurred in the elderly (p = 0.012, 95% confidence interval [CI]: 1.33-9.99). Conclusion: The elderly cases with scrub typhus, murine typhus, or acute Q fever would be more likely to have severe complications, for which prothrombin time prolongation is an important predictor for severe complications. Copyright (C) 2017, Taiwan Society of Microbiology. Published by Elsevier Taiwan LLC.
URI: http://dx.doi.org/10.1016/j.jmii.2016.08.023
http://hdl.handle.net/11536/148870
ISSN: 1684-1182
DOI: 10.1016/j.jmii.2016.08.023
期刊: JOURNAL OF MICROBIOLOGY IMMUNOLOGY AND INFECTION
Volume: 52
起始頁: 54
結束頁: 61
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