Lymphopenia and poor performance status as major predictors for infections among residents in long-term care facilities (LTCFs): a prospective cohort study.
The main aim of this study was to investigate the risk factors and consequence of LTCFs-acquired infections in Taiwan through a 16-month follow-up. This prospective cohort study invited residents of 10 private LTCFs in Taipei for study. For each participant, Karnofsky Performance Scale (KPS), use of feeding tube and/or urinary catheters, serum levels of albumin, total cholesterol, complete blood count, occurrence of LTCF-acquired infections, all-cause mortality were recorded. Overall, a total of 198 LTCF residents entered the study for a total of 67,395 resident-days, and 156 participants (79.8±9.7 years, 51.3% males) complete the follow-up with a total of 67,395 resident-days. During the study period, 360 LTCF-acquired infections occurred, and the incidence was estimated to be 5.34 episodes per 1000 resident-days. Subjects with LTCF-acquired infections were more likely to die than those without infections. Besides, subjects with lymphopenia and long-term use of feeding tube and/or urinary catheters were significant risk factors for LTCF-acquired infections. However, poorer functional status and occurrence of lower respiratory tract infections were significant predictive factors for all-cause mortality. In conclusion, the period prevalence of LTCF-acquired infections was higher in Taiwan than previous reports, but the incidence was similar. In addition to traditional risk factors, lymphopenia, a surrogate indicator for immunosenescence, was a significant risk factor for LTCF-acquired infections.
Department of Family Medicine, Feng-Yuan Hospital, Ministry of Health and Welfare, No. 100, An-Kan Road, Feng-Yuan District, Taichung City 420, Taiwan.
Ching-Jen
CJ
Chang
Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei 112, Taiwan; Aging and Health Research Center, National Yang Ming University, No. 155, Sec. 2, Li-Nong Street, Taipei 116, Taiwan; Institute of Public Health, National Yang Ming University, No. 155, Sec. 2, Li-Nong Street, Taipei 116, Taiwan.
Liang-Yu
LY
Chen
Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei 112, Taiwan; Aging and Health Research Center, National Yang Ming University, No. 155, Sec. 2, Li-Nong Street, Taipei 116, Taiwan.
Li-Kuo
LK
Liu
Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei 112, Taiwan; Aging and Health Research Center, National Yang Ming University, No. 155, Sec. 2, Li-Nong Street, Taipei 116, Taiwan.
Ming-Hsien
MH
Lin
Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei 112, Taiwan; Aging and Health Research Center, National Yang Ming University, No. 155, Sec. 2, Li-Nong Street, Taipei 116, Taiwan; Institute of Public Health, National Yang Ming University, No. 155, Sec. 2, Li-Nong Street, Taipei 116, Taiwan. Electronic address: lining.peng@gmail.com.
Li-Ning
LN
Peng
Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei 112, Taiwan; Aging and Health Research Center, National Yang Ming University, No. 155, Sec. 2, Li-Nong Street, Taipei 116, Taiwan. Electronic address: lkchen2@vghtpe.gov.tw.
Liang-Kung
LK
Chen
D000368:Aged; D000369:Aged, 80 and over; D003428:Cross Infection / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D017567:Karnofsky Performance Status; D008134:Long-Term Care / Q000706:statistics & numerical data*; D008231:Lymphopenia / Q000150:complications / Q000453:epidemiology*; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology
Immunosenescence; Infection; Karnofsky performance status; Long-term care facility; Lymphopenia