بررسی عفونت های رایج سالمندان بستری در بخش عفونی بیمارستان بوعلی قزوین (دوره یک ساله 80-1379)

Background and Aim: In spite of incredible progress in the prophylaxis, diagnosis and treatment of infectious diseases in the elderly, still 30% of the death in these patients is attributed to infections. Immunodeficiency, physiological changes in various organs, lack of classic signs and symptoms of infection such as; fever, leukocytosis, have made difficulties in diagnosis and treatment of such patients. The aim of this study was to describe the most common signs and clinical symptoms of infection in the elderly and to determine the most prevalent infection sites. Materials and Methods: In this descriptive study, by referring to Bou Ali Sina teaching hospital, clinical and paraclinical records of the elderly patients (over 65 Yrs) were investigated between 2000 and 2001. Results: We studied 240 cases; 48.3% females and 51.7% males. The hospitalization period of 59.6% patients was one week. Frequency of admission in 55.2% cases was 2-3 times a year. The most common complaints were weakness (15.6%), gastrintestinal (12.8%), respiratory (12.4%), and urinary (9.9%) symptoms. Also in 31.2% there were localized findings of infection. In 73.5% of the patients an underlying disease was diagnosed. Final diagnoses of admitted patients were Pneumonia (20%), genitourinary tract infection (19.5%), sepsis (13.3%), brucellosis (4.17%), tuberculosis (2.5%), meningitis (2.08%) and other infectious and non infectious diseases (18.75%). The mortality rate among them was about 0.04%. The cause of death in 6 cases was sepsis, in one case urinary tract infection and myocardial infection, in one, opium poisoning, and one bacterial pneumonia due to old tuberculosis. Conclusion: It seems that infection is one of the most common causes of elderly patients' hospitalization. Attention to the clinical findings, especially weakness and loss of power can reveal the initiation of systemic infection. In such a situation early medical care can reduce mortality of the patients, while the presence of underlying diseases (e.g. heart, lung, kidney …) in the process of management should be considered.