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High mortality following norovirus enteritis in hospitalized elderly patients

Abstract number: P1168

Gustavsson L., Andersson L.M., Lindh M., Westin J.

Objectives: Norovirus (NoV), particularly genogroup II (GII), is the leading cause of epidemic gastroenteritis in high-income countries. NoV may contribute to excess mortality in the elderly and chronically ill. The objective of this study was to retrospectively describe the all-cause mortality following NoV infection in hospitalised patients.

Methods: All hospitalised adult patients with a stool sample positive for NoV GII by PCR treated at Sahlgrenska University Hospital, Gothenburg, Sweden, from August 2008 through June 2009, were included. Patient files were reviewed and subjects characterised by age, sex and concurrent medical conditions (immune suppression, renal failure, diabetes, heart failure, malignancy, systemic inflammatory disease or other significant chronic illness). Deaths up to 90 days following the time of positive sampling were noted. In-hospital as well as 30- and 90-day mortality was calculated. c2 test was used to compare proportions. A p-value <0.05 was considered significant.

Results: 606 patients were initially included in the study. There were no deaths among patients less than 60 years old during the study period and these were not included in further analysis. The remaining 539 patients were aged 60 to 101 years, with 58% females. Sixty-two percent were diagnosed with at least one underlying condition. Total mortality rates in-hospital, within 30 and 90 days were 5.9%, 8.5% and 16.7%, respectively. Mortality rates increased with increasing age (see table). Total mortality rates were higher in patients with underlying conditions listed above, as compared to patients without these conditions (all ages combined: 10.5% vs. 5.3% at 30 days, p < 0.05; 21.6% vs. 8.7% at 90 days, p < 0.001). However, when looking at the age group >90 years isolated (n = 106), this difference was not seen.

Conclusion: We found considerable all-cause mortality, in chronically ill as well as in otherwise healthy elderly patients, within the 90 days following a NoV infection, suggesting that NoV may cause excess mortality in these patients.

Age (y)Patients (n)30-day mortality (%)90-day mortality (%)
60–69631.611.1
70–791085.613.1
80–892629.216.8
90+10614.223.6

Session Details

Date: 10/04/2010
Time: 00:00-00:00
Session name: Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases
Subject:
Location: Vienna, Austria, 10 - 13 April 2010
Presentation type:
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