ABSTRACT
BACKGROUND: Increasing attention has been given to the care to elderly patients in emergency departments (ED). Moreover, few data are available about final phase of the process, that is hospital admission from ED. This study was conducted to establish appropriateness, reasons and social factors related to hospital admission in medical services from ED and their age-related differences. METHODS: The Appropriateness Evaluation Protocol scale (AEP) was applied prospectively to 515 patients 15 years and older admitted to medical services through an ED. Patients who did not meet any AEP criteria were evaluated for other medical or social factors as conditions for their admission. RESULTS: The sample was composed by 303 elders (65 years and older, mean age = 77 +/- 6 years) and 212 adults (15-64 years old, mean age = 45 +/- 14). 271 elderly patients (89.4%) and 173 adults (81.6%) meet AEP criteria (p = 0.01). Hospitalary admission for diagnostic procedures is more frequent in younger than in older group (14.2% versus 6.9%, p = 0.01). No differences are detected in hospital admissions based upon strictly social factors: 7 (2.3%) in elderly group and 7 (3.3%) in younger one (p = 0.05). CONCLUSIONS: Urgent hospital admissions in medical services are justified more frequently in elderly patients. These patients are admitted for diagnostic procedures less frequently than younger group. No age-dependent difference in strictly social admissions is detected.
Subject(s)
Emergencies , Hospitalization/statistics & numerical data , Age Factors , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Prospective Studies , SociologyABSTRACT
An analysis of the epidemiology of the human immunodeficiency virus infection in the Basque Country, Spain is presented. The infection by this virus is mainly detected in intravenous drug addicts. In homosexuals the seropositivity frequency detected was moderate, and infection was also detected in sexual partners of drug addicts.
Subject(s)
Acquired Immunodeficiency Syndrome , HIV Seropositivity/epidemiology , HIV Seroprevalence , Humans , Risk Factors , Spain/epidemiologyABSTRACT
An analysis of the medical pathologies seen in heroin addicts heroin addicts hospitalized in the Provincia de Vizcaya, Basque Country, Spain, from 1982 to 1987, and its possible association to the infection by the human immunodeficiency virus, HIV, is presented. An increasing of hospitalized addicts per year was observed, being infectious diseases the main pathology detected. HIV infection was present in more than 90% of individuals with non opportunistic acquired infections. Significant annual increase in the number of tuberculosis and candida infections was present. The possible association of HIV infection with increased susceptibility to commonly acquired non opportunistic infections is discussed.
Subject(s)
HIV Seropositivity/epidemiology , Heroin Dependence/complications , Infections/etiology , Follow-Up Studies , Hospitalization , Humans , Spain/epidemiologyABSTRACT
Serum samples from 313 asymptomatic intravenous (IV) drug users from Bilbao (Vizcaya, Vasque Country, Spain) were tested for antibodies to HTLV-III/LAV virus, the probable etiologic agent of the acquired immune deficiency syndrome (AIDS). Viral antibodies were assayed by ELISA test. 41.9% of the sera gave positive reactions. No seropositivity was detected among 22 normal blood donors, 58 chronic alcoholics, or 20 members of the Drug Control Center personnel. Virus specific reactions were confirmed by indirect immunofluorescence using an HTLV-III/LAV producer cell line, and by Western blotting. 55% of the ELISA-positive sera were also positive in Western blot assay. No differences in seropositivity by age or sex were observed but it increased with the period of parenteral drug use. Presence of antibody statistically correlated with the frequency of syringe sharing, confirming the transmission of viral infection by blood products. Altered T4/T8 ratios and lower number of T4 positive lymphocytes were detected among HTLV-III/LAV positive drug addicts.
