title: Comparison of morbidity of elderly patients in August and November in Attica, Greece: a prospective study.
abstract: BACKGROUND
  In our clinical practice, we have experienced a consistent increase in the morbidity of elderly in Greece during August.
  
  
  METHODS
  We prospectively analysed and compared the morbidity of elderly patients (≥ 75 years old) between August and November of the same year (2010), using data from the SOS Doctors (a network of physicians performing house call visits).
  
  
  RESULTS
  We analysed data on 739 and 738 elderly patient house-calls in August and November, respectively. Overall, the most common diagnoses were cardiovascular (17.6%), musculoskeletal (10.7%), gastrointestinal (9.5%), respiratory (8.5%), renal/genitourinary (8.1%), and neurologic/psychiatric (7.9%). In August, patients were older (p < 0.01), carried a heavier burden of disease (as inferred by specific types of comorbidity and associated medical conditions), were more frequently recommended emergency hospitalization (p < 0.01) and had a worse outcome of primary illness (p < 0.05). Mortality of elderly visited in August was significantly higher compared to November (5% vs. 2%, p < 0.01). The sole independent predictor of mortality was patient's bedridden status [adjusted odds ratio (OR) = 5.59, 95% confidence intervals (CI) 2.83-11.06, p < 0.001]. The identified independent predictors of recommendation for emergency hospitalization were patient's lethargic status [OR = 2.88 (1.80, 4.59), p < 0.001], fever [OR = 2.55 (1.84, 3.54), p < 0.001], heat stroke [OR = 2.08 (1.19, 3.64), p = 0.01], Alzheimer's disease [OR = 1.77 (1.15, 2.72), p = 0.01] and bedridden status [OR = 1.45 (1.07, 1.97), p < 0.05].
  
  
  CONCLUSIONS
  Morbidity and mortality of elderly patients was significantly higher in August compared with November, substantiating the informal term 'Augustitis' for the Greek elderly. Large, prospective population-based studies are warranted to further enlighten this field.
authors.affiliation: SOS Doctors, Athens, Greece.
authors.forename: G
authors.initials: G
authors.lastname: Theocharis
authors.forename: M N
authors.initials: MN
authors.lastname: Mavros
authors.forename: E K
authors.initials: EK
authors.lastname: Vouloumanou
authors.forename: G
authors.initials: G
authors.lastname: Peppas
authors.forename: S G
authors.initials: SG
authors.lastname: Barbas
authors.forename: T
authors.initials: T
authors.lastname: Spiropoulos
authors.forename: M E
authors.initials: ME
authors.lastname: Falagas
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017281:Cost of Illness; D004630:Emergencies / Q000453:epidemiology; D005260:Female; D006115:Greece / Q000453:epidemiology; D006304:Health Status; D006760:Hospitalization / Q000706:statistics & numerical data; D006792:House Calls / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009017:Morbidity; D009026:Mortality; D011379:Prognosis; D011446:Prospective Studies; D013997:Time Factors