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Hospitalizations Involving Gastroenteritis in the United States, 1985: The Special Burden of the Disease among the Elderly
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1992
Year
Diarrheal DiseaseGastroenterologyGeriatric MedicineUnited StatesTraveler DiarrheaDischarge DiagnosisHospital MedicinePediatric EpidemiologyClinical EpidemiologyGastrointestinal VirusIntestinal PhysiologyPublic HealthHealth Services ResearchPediatric Emergency MedicineGeneral EpidemiologyHospital EpidemiologyGeriatricsSpecial BurdenEpidemiologyDigestive System DiseasesHospitalizationPatient SafetyPediatricsPediatric GastroenterologyDiarrheal DeathsClinical GastroenterologyGastrointestinal PathologyMedicineEmergency Medicine
Diarrheal disease is well known in children, but its impact on the elderly has been inadequately studied. The study examined 4.06 million 1985 hospitalizations, focusing on 87,181 cases where gastroenteritis was among the top three diagnoses, including 514 deaths. Gastroenteritis accounts for 9 % of hospitalizations in children 1–4 years but only 1.5 % in adults, yet it causes 85 % of diarrheal deaths, with a 3 % fatality rate in those ≥80 years versus 0.05 % in children <5, making age the strongest risk factor (OR ≈ 52.6).
While diarrheal disease is a well-recognized problem in children, its impact in the elderly has not been adequately assessed. Among the 4.06 million hospitalizations in 1985 in the McDonnell-Douglas Health Information System database, 98,185 hospitalizations, including 1,130 deaths, had gastroenteritis recorded as a discharge diagnosis. The authors analyzed the 87,181 hospitalizations and 514 deaths for which gastroenteritis was one of the top three diagnoses. Gastroenteritis was among the top three diagnoses in 9% of all hospitalizations of children 1-4 years of age, compared with 1.5% of hospitalizations throughout adulthood (greater than or equal to 20 years). Only 0.05% of hospitalizations involving gastroenteritis were fatal for children younger than 5 years, compared with 3% in individuals 80 years or older. While children aged less than 5 years and adults aged 60 years or more each comprised one-fourth of hospitalizations involving gastroenteritis, the older group represented 85% of diarrheal deaths. Age was the most important risk factor for death subsequent to a hospitalization involving gastroenteritis (odds ratio = 52.6, 95% confidence interval 37.0-76.9 for age greater than or equal to 70 years vs. less than 5 years). Gastroenteritis is a large, underemphasized public health problem among the elderly, among whom its case-fatality ratio is higher than in children.