[Emergency room transfers for residents of the 16th arrondissement of Paris]. / Transferts aux urgences des résidents d'Ehpad du 16e arrondissement de Paris.

Access to care for the population residing in residential facilities for dependent elderly people (Ehpad), i.e. 600,000 people in France in 2019, is a major public health issue. Description of the characteristics and pathways of the residents of Ehpad transferred to the emergency department (SAU) in the Paris 16th district.

Molecular investigation of a RSV outbreak in a geriatric hospital.

BACKGROUND: Acquired infections in hospitalized elderly people are a growing concern. In long-term care facilities with multiple staff and visitor contacts, virus outbreaks are a common challenge for infection prevention teams. Although several studies have reported nosocomial RSV outbreaks in long term care facilities, molecular epidemiology data are scarce. METHODS: RSV RNA was detected in respiratory samples from 19 patients in a long-term care hospital for elderly in Paris in March 2019 over a 3 weeks period. Genotyping was performed using nucleotide sequencing. Sociodemographic and clinical characteristics of cases part of a unique cluster, were retrospectively reviewed. RESULTS: Molecular investigation of theses RSV cases, revealed a unique cluster of 12 nosocomial cases in 2 adjacent wards. Mean age of these outbreak's cases was 89. All patients had underlying medical conditions. Seven exhibited lower respiratory symptoms and three experienced decompensation of underlying chronic heart condition. Two patients died. CONCLUSIONS: This case report highlights the importance of RSV in causing substantial disease in elderly in case of nosocomial outbreak and the contributions of molecular epidemiology in investigation and management of such outbreak.

[First year prognosis of patients hospitalized in an acute geriatric ward with a known dementia or newly diagnosed]. / Devenir à un an des patients hospitalisés en court séjour gériatrique, avec un syndrome démentiel connu, ou nouvellement diagnostiqué.

In France, only a third of demented patients have an established diagnostic of dementia. Hospitalization is often an opportunity to perform a diagnostic of dementia. Real benefits for patients of such a diagnostic process are unknown. The objective of the study was to observe prognosis of elderly patients hospitalized in geriatric courses in terms of mortality, hospitalization rate and entry into an institution. This was a monocentric prospective study with a one-year follow-up of 90 patients hospitalized in an acute geriatric ward with either dementia known by general practitioner, either diagnosed during the hospitalization according to DSM IV criteria. A one year follow-up by phone has been conducted. From a consecutive set of 159 inpatients for 18 weeks, we included in this study 49 patients with a known dementia (group 1, mean age 85.7±4.6 years, mean Mini-mental state examination (MMSE) score 12.4±6.2) and 41 patients with dementia diagnosed during hospitalization (group 2, mean age 88.4±6.4 years, mean MMSE score 16.1±6.5). Differences between the two groups were significant for age (p<0.03) and MMSE score (p<0.02). One-year mortality rate was near 30% in the 2 groups. Rate of institutionalization was 33% in group 1 and 49% in group 2 (not statistically significant). There was a significant difference in number of days spent at home between group 1 and group 2, respectively 190.9±159.9 days vs 111.1±148.1 days (p<0.03). Demented patients previously diagnosed lived longer at home at one year than patients newly diagnosed. These results tend to support the diagnosis of dementia in very elderly patients with multiple comorbidities. Conditions of living at home, in particular the quality of life, should be the object of further studies.