<p>In all 894 individuals who underwent RT-PCR testing (reference standard) were screened a... more <p>In all 894 individuals who underwent RT-PCR testing (reference standard) were screened as potential eligible participants. Among them 207 were excluded because of missing files. So 687 were included in the study: 220 had negative RT-PCR and 467 had positive RT-PCR. Among the 220 individuals with negative RT-PCR, 14 had missing data for the score, 145 were classified as negative by both the score and the RT-PCR (true negative), and 61 were classified as positive by the score while being negative with the RT-PCR (false positive). Among the 467 individuals with positive RT-PCR, 10 had missing data for the score, 396 were classified as positive by both the score and the RT-PCR (true positive), and 61 were classified as negative by the score while being positive with the RT-PCR (false negative).</p
<p>Bivariable and multivariable analyses of predictors of CHIK+ status using logistic regre... more <p>Bivariable and multivariable analyses of predictors of CHIK+ status using logistic regression, and the corresponding weighted point values of the score.</p
<p>The Receiver Operating Characteristic (ROC) Curve is a plot of the true positive rate (S... more <p>The Receiver Operating Characteristic (ROC) Curve is a plot of the true positive rate (Sensitivity) against the false positive rate (1-Specificity). The cut-off value represents the point on the curve that maximizes both sensitivity and specificity. In this analysis, the cut-off value identified to best distinguish between CHIK+ and CHIK- patients was 12 points (★).</p
Tropical Medicine & International Health, 2018
ObjectiveTo investigate whether the long‐term survival in elderly patients with prior Chikungunya... more ObjectiveTo investigate whether the long‐term survival in elderly patients with prior Chikungunya virus infection (CVI) is associated with the clinical form presented in the acute phase, as defined by the WHO classification.MethodsRetrospective cohort study performed in Martinique University Hospitals. Patients who attended the emergency department for suspected CVI, and who had a positive biological diagnosis of CVI by reverse transcription‐polymerase chain reaction on a plasma sample between 10 January and 31 December 2014 were eligible for inclusion. Time‐to‐death was the primary outcome. The independent relationship between clinical forms and time‐to‐death was analysed using a Cox model.ResultsIn total, 268 patients were included. Mean age was 80 ± 8 years, 53% were women. Median length of follow‐up was 28 months (range: 0–39). During follow‐up, 53 (19.8%) patients died. Median survival time was 13.2 months (range: 0–33.6). At the end of follow‐up, death rates were 4.6% for acut...
ObjectivesTo assess the frequency of diagnostic errors in older adults presenting to the emergenc... more ObjectivesTo assess the frequency of diagnostic errors in older adults presenting to the emergency department (ED) with symptoms suggestive of Chikungunya virus infection (CVI) and to compare the rates of misdiagnosis of older and younger adults.DesignCross‐sectional study performed in the University Hospitals of Martinique from retrospective cases.SettingEmergency department.ParticipantsIndividuals aged 65 and older who attended the ED and underwent reverse transcription polymerase chain reaction (RT‐PCR) testing for CVI between January and December 2014 (n=333, mean age 80±8) were considered eligible and were compared with a randomly selected sample of younger adults (< 65) (n=143, mean age 45±13).MeasurementsMisdiagnosis rates.ResultsThe rate of misdiagnosis of CVI in the ED was 30.6% in individuals aged 65 and older and 6.3% in those younger than 65 (p<.001). The overdiagnosis rate was 9.0% in individuals aged 65 and older and 3.5% in those younger than 65 (p=.04). The und...
ObjectivesWe aimed to determine whether the presentation of Chikungunya virus (CHIKV) infection d... more ObjectivesWe aimed to determine whether the presentation of Chikungunya virus (CHIKV) infection differs between older and younger adults with regard to clinical form during the acute phase defined by the World Health Organization: acute clinical, atypical, and severe acute.DesignCross‐sectional, retrospective.SettingUniversity Hospital of Martinique.ParticipantsIndividuals aged 65 and older (n = 267, mean age 80.4 ± 87.9) who attended the emergency department with a positive biological diagnosis of CHIKV (reverse transcriptase polymerase chain reaction) between January and December 2014 and a randomly selected sample of individuals younger than 65 (n = 109, mean age 46.2 ± 12.7).ResultsTypical presentation was present in 8.2% of older adults and 59.6% of younger individuals (P < .001), atypical presentation in 29.6% of older adults and 5.6% of younger individuals (P < .001), and severe presentation in 19.5% of older adults and 17.4% of younger individuals (P = .65). One hundre...
Introduction : L’objectif principal de ce travail est de determiner les facteurs de risque de mor... more Introduction : L’objectif principal de ce travail est de determiner les facteurs de risque de mortalite par cancer a 18 mois dans une population de sujets âges hospitalises en medecine geriatrique. L'objectif secondaire est de demontrer lesquels de ces meme facteurs influent sur la decision de prise en charge palliative versus curative. Methode : Il s’agit d’une etude retrospective monocentrique, realisee dans les services de medecine geriatrique du CHU de Bordeaux des patients de 80 ans chez qui un cancer incident a ete diagnostique entre le 1er janvier 2013 et le 31 decembre 2014. Resultats : 133 patients ont ete inclus dans l’etude. A 18 mois, 61% des patients etaient decedes de leur cancer. Au sein de la population etudiee, seuls 20,7% ont recu un traitement curatif. L’absence de troubles cognitifs (OR, 6,4; IC 95%, 1,052 a 38,803; p=0,04), d’antecedent de cancer (OR, 3,5; IC 95%, 1,080 a 11,618; p=0,04) et l’administration d’un traitement palliatif (OR, 14,6; IC 95%, 2,684 ...
<p>In all 894 individuals who underwent RT-PCR testing (reference standard) were screened a... more <p>In all 894 individuals who underwent RT-PCR testing (reference standard) were screened as potential eligible participants. Among them 207 were excluded because of missing files. So 687 were included in the study: 220 had negative RT-PCR and 467 had positive RT-PCR. Among the 220 individuals with negative RT-PCR, 14 had missing data for the score, 145 were classified as negative by both the score and the RT-PCR (true negative), and 61 were classified as positive by the score while being negative with the RT-PCR (false positive). Among the 467 individuals with positive RT-PCR, 10 had missing data for the score, 396 were classified as positive by both the score and the RT-PCR (true positive), and 61 were classified as negative by the score while being positive with the RT-PCR (false negative).</p
<p>Bivariable and multivariable analyses of predictors of CHIK+ status using logistic regre... more <p>Bivariable and multivariable analyses of predictors of CHIK+ status using logistic regression, and the corresponding weighted point values of the score.</p
<p>The Receiver Operating Characteristic (ROC) Curve is a plot of the true positive rate (S... more <p>The Receiver Operating Characteristic (ROC) Curve is a plot of the true positive rate (Sensitivity) against the false positive rate (1-Specificity). The cut-off value represents the point on the curve that maximizes both sensitivity and specificity. In this analysis, the cut-off value identified to best distinguish between CHIK+ and CHIK- patients was 12 points (★).</p
Tropical Medicine & International Health, 2018
ObjectiveTo investigate whether the long‐term survival in elderly patients with prior Chikungunya... more ObjectiveTo investigate whether the long‐term survival in elderly patients with prior Chikungunya virus infection (CVI) is associated with the clinical form presented in the acute phase, as defined by the WHO classification.MethodsRetrospective cohort study performed in Martinique University Hospitals. Patients who attended the emergency department for suspected CVI, and who had a positive biological diagnosis of CVI by reverse transcription‐polymerase chain reaction on a plasma sample between 10 January and 31 December 2014 were eligible for inclusion. Time‐to‐death was the primary outcome. The independent relationship between clinical forms and time‐to‐death was analysed using a Cox model.ResultsIn total, 268 patients were included. Mean age was 80 ± 8 years, 53% were women. Median length of follow‐up was 28 months (range: 0–39). During follow‐up, 53 (19.8%) patients died. Median survival time was 13.2 months (range: 0–33.6). At the end of follow‐up, death rates were 4.6% for acut...
ObjectivesTo assess the frequency of diagnostic errors in older adults presenting to the emergenc... more ObjectivesTo assess the frequency of diagnostic errors in older adults presenting to the emergency department (ED) with symptoms suggestive of Chikungunya virus infection (CVI) and to compare the rates of misdiagnosis of older and younger adults.DesignCross‐sectional study performed in the University Hospitals of Martinique from retrospective cases.SettingEmergency department.ParticipantsIndividuals aged 65 and older who attended the ED and underwent reverse transcription polymerase chain reaction (RT‐PCR) testing for CVI between January and December 2014 (n=333, mean age 80±8) were considered eligible and were compared with a randomly selected sample of younger adults (< 65) (n=143, mean age 45±13).MeasurementsMisdiagnosis rates.ResultsThe rate of misdiagnosis of CVI in the ED was 30.6% in individuals aged 65 and older and 6.3% in those younger than 65 (p<.001). The overdiagnosis rate was 9.0% in individuals aged 65 and older and 3.5% in those younger than 65 (p=.04). The und...
ObjectivesWe aimed to determine whether the presentation of Chikungunya virus (CHIKV) infection d... more ObjectivesWe aimed to determine whether the presentation of Chikungunya virus (CHIKV) infection differs between older and younger adults with regard to clinical form during the acute phase defined by the World Health Organization: acute clinical, atypical, and severe acute.DesignCross‐sectional, retrospective.SettingUniversity Hospital of Martinique.ParticipantsIndividuals aged 65 and older (n = 267, mean age 80.4 ± 87.9) who attended the emergency department with a positive biological diagnosis of CHIKV (reverse transcriptase polymerase chain reaction) between January and December 2014 and a randomly selected sample of individuals younger than 65 (n = 109, mean age 46.2 ± 12.7).ResultsTypical presentation was present in 8.2% of older adults and 59.6% of younger individuals (P < .001), atypical presentation in 29.6% of older adults and 5.6% of younger individuals (P < .001), and severe presentation in 19.5% of older adults and 17.4% of younger individuals (P = .65). One hundre...
Introduction : L’objectif principal de ce travail est de determiner les facteurs de risque de mor... more Introduction : L’objectif principal de ce travail est de determiner les facteurs de risque de mortalite par cancer a 18 mois dans une population de sujets âges hospitalises en medecine geriatrique. L'objectif secondaire est de demontrer lesquels de ces meme facteurs influent sur la decision de prise en charge palliative versus curative. Methode : Il s’agit d’une etude retrospective monocentrique, realisee dans les services de medecine geriatrique du CHU de Bordeaux des patients de 80 ans chez qui un cancer incident a ete diagnostique entre le 1er janvier 2013 et le 31 decembre 2014. Resultats : 133 patients ont ete inclus dans l’etude. A 18 mois, 61% des patients etaient decedes de leur cancer. Au sein de la population etudiee, seuls 20,7% ont recu un traitement curatif. L’absence de troubles cognitifs (OR, 6,4; IC 95%, 1,052 a 38,803; p=0,04), d’antecedent de cancer (OR, 3,5; IC 95%, 1,080 a 11,618; p=0,04) et l’administration d’un traitement palliatif (OR, 14,6; IC 95%, 2,684 ...
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