Mortality associated with an influenza outbreak on a dementia careunit
G.H. Brandeis
Bok Engelsk 1998
| Utgitt | 1998
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| Omfang | Side 140- 145
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| Opplysninger | The purpose of this study was to describe an episode of increasedmortality, whose cause was initially unknown. This retrospectivecohort investigation was conducted on a dementia special care unit ofa Department of Veterans Affairs facility with more than 75% ofresidents clinically diagnosed with dementia of the Alzheimer type.One hundred five residents residing in the facility during February1995 were included as subjects. A cluster of deaths occurred,triggering the investigation. Ultimately, 21 deaths (three timesgreater than any previous month in the past 5 years) occurred duringthe 1-month period. Measures included the presence of clinicalinfluenza-like illness based on signs, serology, and autopsy results.Of the 105 residents, 45 (42.8%) met the clinical definition forinfluenza-like illness. Eight autopsies were performed, and thecauses of death consisting of bronchopneumonia in seven andaspiration pneumonia in one were compatible with influenza. Therewere no differences among those who died ham those who lived withregards to age, race, gender, clinical influenza-like illness,vaccination status, diagnosis of Alzheimer disease, or duration ofdementia (all p greater than or equal to 0.2). However, those whodied were at a higher risk of dying due to a greater number ofcoexisting conditions (p < 0.01). Also, overall the groups differedin Mini-Mental State Examination and Bedford Alzheimer Nursing Scalescares with those who died being more impaired (p < 0.01). Thus, thepresentation of influenza-like illness can be subtle in onset,underappreciated in this population, and not recognized until excessmortality, which affects the most frail, is noted. Care providersneed to be vigilant during the winter months for the presence ofinfluenza.
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