"Adults 65 years or older (older adults) account for a disproportionate share of patients with infectious disease (ID) – related hospitalizations and all-cause hospitalizations in the United States," according to background information in the article. From 1980 through 1994, rates of infectious disease hospitalizations increased among older adults, while rates for those younger than 65 years decreased. The number of older adults is expected to increase from 35 million in 2000 to 69 million by 2030, accounting for approximately one fifth of the total U.S. population.
Aaron T. Curns, M.P.H., of the Centers for Disease Control and Prevention, Atlanta, and colleagues, examined the National Hospital Discharge Survey (NHDS) to estimate older adult hospitalization rates from 1990 through 2002. The NHDS is a national probability survey that collects data annually from a sample of about 270,000 inpatient records from approximately 500 hospitals.
From 1990 through 2002, there were approximately 21.4 million ID hospitalizations among older adults, 48 percent of which had an ID as the primary diagnosis. Between 1990 through1992 and 2000 through 2002, there was a 13 percent increase in the ID hospitalization rate, from 449.4 to 507.9 hospitalizations per 10,000 older adults. Nearly half of ID hospitalizations (46 percent) and ID-related hospitalization deaths (48 percent) were associated with lower respiratory tract infections from 2000 through 2002. The hospitalization rates for lower respiratory tract infections and kidney, urinary tract, and bladder infections did not change significantly. The rate for septicemia (infection of the bloodstream), however, increased 22 percent from 50.4 to 61.7 hospitalizations per 10,000 older adults from 1990 through 1992 to 2000 through 2002. Rates for infections of the heart, infections and inflammatory reactions to prosthetic devices, and postoperative infections had the most dramatic growths, with increases of approximately 240 percent, 130 percent and 80 percent, respectively.
"The hospitalization rate for IDs increased slightly among the older adult U.S. population during the 13-year study and was associated with the aging of the older adult population," the authors write. "The reduction of ID hospitalization rates among older adults could help attenuate the anticipated increase in the number of hospitalizations among older adults and should be a high priority given the projected population growth among older adults in the United States."
(Arch Intern Med. 2005; 165: 2514 – 2520. Available pre-embargo to the media at www.jamamedia.org.)
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Journal
Archives of Internal Medicine