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Infectious Disease in Older Americans Sends Many to ED

BOSTON – Despite common assumptions, most of the older adults presenting to the emergency department aren’t suffering heart attacks or other cardiac-related ailments.

In fact, according to a report in the Journal of the American Geriatrics Society, infectious diseases account for 13.5% of ED visits involving patients age 65 or older, which is a higher percentage than for emergency care sought for heart attacks and congestive heart failure combined.

The highest rate of ED visits for infectious diseases was among patients 85 years old and older, notes the study, which involved researchers from Harvard University and the University of Fukui Hospital in Japan.

The review found that lower respiratory tract infections, such as pneumonia, made up about a fourth of the ED visits for infectious diseases, with pneumonia itself accounting for 17.5% of those visits.

Lower respiratory tract infections also were responsible for 15% of the infectious disease-related deaths during ED visits and after admission.

Septicemia, meanwhile, was the diagnosis in 32% of infectious disease-related admissions and 75% of infectious disease-related deaths during ED visits and hospitalizations. Urinary tract infections accounted for 25.3% of the infectious disease ED visits.

For the study, researchers examined more than 3 million ED visits related to infectious diseases, with 57% resulting in hospitalizations in that group; the percentage of hospitalization went up to 66.5% for patients age 85 and older. Of those patients, 123,894, 4%, died during the ED visit or subsequent hospitalization.

Study authors point out that higher immunization rates for influenza and pneumonia could make a significant difference in morbidity and mortality related to infectious disease for older patients.

A recent study from the national Centers for Disease Control and Prevention says that the influenza vaccination rate was 71.5% and pneumococcal vaccination coverage was 61.3% among adults aged 65 and older in 2014.

While still lower than recommended, reported pneumococcal vaccination coverage (23-valent pneumococcal polysaccharide vaccine [PPSV23] and 13-valent pneumococcal conjugate vaccine [PCV13]) among older adults still was almost triple the 20.3% rate for adults 19–64 considered at high risk, the CDC said.