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. 2022 Sep 13:4:912469.
doi: 10.3389/fmedt.2022.912469. eCollection 2022.

Infections and hospital bed-days among aging adults: A five-year retrospective study in a Belgian general hospital

Anne-Marie De Cock  1 , Danielle Strens  2 , Peter Van Osta  1 , Baudouin Standaert  3   4
Affiliations

Infections and hospital bed-days among aging adults: A five-year retrospective study in a Belgian general hospital

Anne-Marie De Cock et al. Front Med Technol. .

Abstract

Background: Infectious disease in aging adults (≥61 years) often occurs in combination with other health conditions leading to long hospital stays. Detailed studies on infection in aging adults investigating this problem are sparse.

Aim: To quantify the effect of primary and secondary diagnosed infections on hospitalization bed-days among aging adult patients.

Design: Retrospective patient-file study.

Setting: Ziekenhuis Netwerk Antwerpen (ZNA) Hospital, a 1,858-bed general hospital in Belgium, with 364 beds allocated to geriatric patients.

Data source: Database of hospitalized adult patients aged ≥61 years.

Methods: All adult patients aged ≥61 years hospitalized on two wards, Geriatrics and Pulmonology, from 2010 to 2014 were included. Primary diagnosed infections were defined as infections known at entry to be treated first. Secondary diagnosed infections included infections known at entry but treated in parallel to primary non-infectious causes of entry, infections unknown at entry, and hospital-acquired (nosocomial) infections. Data were analyzed by patient age, gender, year, ward type, bed-days of hospitalization, infection rates, and seasonality.

Results: There were 3,306 primary diagnosed infections (18%) and 14,758 secondary infections (82%) identified in the two wards combined (54.7% of all hospital stays at those 2 wards). Secondary diagnosed infections accounted for a significantly higher proportion of hospitalizations in both wards (+40% for Geriatric ward; +20% for Pulmonology ward; p < 0.001) and were associated with a significantly longer average hospital stay (+4 days for Geriatric ward; +5 days for Pulmonology ward; p < 0.001). Nosocomial infections (12% for Geriatric ward; 7% for Pulmonology ward) were associated with particularly high bed-days of hospitalization, at approximately +15 days and +12 days on Geriatric and Pulmonology wards, respectively. Both wards showed marked seasonality for respiratory infections with winter peaks.

Conclusion: Real-world data showed that secondary diagnosed infections in aging adults imposed a high burden on hospital care along with longer hospital stays. This hampered bed availability during peak seasons.

Keywords: aging adults; geriatrics; hospitalization; infectious disease; pulmonology.

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Conflict of interest statement

BS is employed by HEBO. DS is employed by Realidad. BS has received consultancy fees, unrelated to the present work, from GSK Vaccines, Biondvax, and Evidera-PMM. DS received a consultancy fee from GSK Vaccines to initiate the study in 2019. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Overview of the baseline information obtained at the start of the project about the study population and the objectives of the study program.
Figure 2
Figure 2
(A) Distribution of hospital stays (cumulative over the observation period) by age and gender in the geriatric ward. (B) Distribution of hospital stays (cumulative over the observation period) by infection category in the geriatric ward.
Figure 3
Figure 3
(A) Distribution of hospital stays (cumulative over the observation period) by age and gender in the pulmonology ward. (B) Distribution of hospital stays (cumulative over the observation period) by infection category in the pulmonology ward.
Figure 4
Figure 4
(A) Time trend in the age distribution per year for the geriatric ward. (B) Time trend for accumulated hospital bed-days (bars) with hospital stays (line) per year in the geriatric ward.
Figure 5
Figure 5
(A) Time trend in the age distribution per year for the pulmonology ward. (B) Time trend for accumulated hospital bed-days (bars) with hospital stays (line) per year in the pulmonology ward.
Figure 6
Figure 6
Average hospital bed-days by infection category over the years of observation for the geriatric ward.
Figure 7
Figure 7
Infection rate overall and for the different infection categories per 1,000 bed-days occupied during the observation period (2010–2014) by age group in the geriatric ward.
Figure 8
Figure 8
The observed relationship between average bed-days per stay by infection category measured per year and the rate of infection for each category in the geriatric (squares) and pulmonology wards (circles). G, Geriatric; P, Pulmonology.
Figure 9
Figure 9
(A) Slope of hospitalization bed-days for different infection categories in the geriatric ward. (B) Slope of hospitalization bed-days for different infection categories in the pulmonology ward.
Figure 10
Figure 10
Cumulative seasonality trends for overall infections in the pulmonary ward and for respiratory diseases in the geriatric ward.
See this image and copyright information in PMC

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