[Serum albumin level as a predictor of incidence of febrile episodes and mortality in hospitalized geriatric patients]

Neutrophil CD64 level as a rapid and promising diagnostic tool for infectious diseases in elderly patients

AIM

We examined the utility of the neutrophil CD64 level as a rapid and sensitive diagnostic marker for infections in febrile aged patients.

METHODS

The expression level of CD64 per neutrophil was quantitatively measured with flow cytometry using a QuantiBrite kit in samples from febrile (aged >65 years) patients. Information about the presence or absence of infectious disease was retrospectively obtained from each patient's medical record in which attending physicians were obliged to write down a tentative diagnosis after resolution of manifestations.

RESULTS

With receiver operating characteristic curve evaluation using the results, a CD64 level >2000 molecules per neutrophil was sensitive and specific for detecting infection. Among 102 patients suspected of having infection, 72 patients were diagnosed with infectious diseases, and 30 patients had non-infectious diseases. The sensitivity and specificity of determination of the neutrophil CD64 level were 88% and 63%, respectively. However, considering the high frequency of infections in elderly patients (71% in the present study), the post-test probability reached as high as 93%. The positive likelihood ratio was 2.4, and the negative likelihood ratio was 0.2.

CONCLUSIONS

Considering the frequency of infectious diseases in elderly patients, determination of the neutrophil CD64 level helps detect infectious diseases.

Reducing waiting lists for hospital admission: community nutrition services reduce the need for hospital beds

The number of hospital beds needed is greatly increased by the malnutrition of patients before admission and after discharge. Malnourished patients spend longer in hospital and are more likely to die following surgery or other treatment. Extensive studies show that low blood serum albumin, indicating protein deficiency, is a major risk factor for morbidity and mortality among hospital patients. Community food and nutrition services are extending throughout the developed world as part of public health policies. Such services can reduce costs by reducing the need for hospital beds, can reduce waiting lists and save the lives of many hospital patients. Preventive nutrition services can give financial benefits much exceeding costs.