Ilker Uçkay1,2, Dominique Holy3, Michael Betz4, Regina Sauer5, Tanja Huber6, Jan Burkhard7,3. 1. Infectiology, Balgrist University Hospital, Forchstrasse 340, 8008, Zurich, Switzerland. ilker.uckay@balgrist.ch. 2. Infection Control, Balgrist University Hospital, Zurich, Switzerland. ilker.uckay@balgrist.ch. 3. Internal Medicine, Balgrist University Hospital, Zurich, Switzerland. 4. Orthopaedic Surgery, Balgrist University Hospital, Zurich, Switzerland. 5. Nursing Care, Balgrist University Hospital, Zurich, Switzerland. 6. Pharmacy, Balgrist University Hospital, Zurich, Switzerland. 7. Infection Control, Balgrist University Hospital, Zurich, Switzerland.
Abstract
BACKGROUND: With the increasing number of elderly patients, arthroplasties, fractures and diabetic foot infections, the worldwide number of osteoarticular infections (OAI) among the elderly is concomitantly expected to rise. AIMS: We explore existing scientific knowledge about OAI in the frail elderly population. METHODS: We performed a literature search linking OAIs to geriatric patients and comparing elderly patients (> 65 years) with average adults (range 18-65 years). RESULTS: In this literature, financial aspects, comparison of diverse therapies on quality of life, reimbursement policies, or specific guidelines or nursing recommendations are missing. Age itself was not an independent factor related to particular pathogens, prevention of OAI, nursing care, and outcomes of OAI. However, geriatric patients were significantly more exposed to adverse events of therapy. They had more co-morbidities and more conservative surgery for OAI. CONCLUSION: Available literature regarding OAI management among elderly patients is sparse. In recent evaluations, age itself does not seem an independent factor related to particular epidemiology, pathogens, prevention, nursing care, rehabilitation and therapeutic outcomes of OAI. Future clinical research will concern more conservative surgical indications, but certainly reduce inappropriate antibiotic use.
BACKGROUND: With the increasing number of elderly patients, arthroplasties, fractures and diabetic foot infections, the worldwide number of osteoarticular infections (OAI) among the elderly is concomitantly expected to rise. AIMS: We explore existing scientific knowledge about OAI in the frail elderly population. METHODS: We performed a literature search linking OAIs to geriatric patients and comparing elderly patients (> 65 years) with average adults (range 18-65 years). RESULTS: In this literature, financial aspects, comparison of diverse therapies on quality of life, reimbursement policies, or specific guidelines or nursing recommendations are missing. Age itself was not an independent factor related to particular pathogens, prevention of OAI, nursing care, and outcomes of OAI. However, geriatric patients were significantly more exposed to adverse events of therapy. They had more co-morbidities and more conservative surgery for OAI. CONCLUSION: Available literature regarding OAI management among elderly patients is sparse. In recent evaluations, age itself does not seem an independent factor related to particular epidemiology, pathogens, prevention, nursing care, rehabilitation and therapeutic outcomes of OAI. Future clinical research will concern more conservative surgical indications, but certainly reduce inappropriate antibiotic use.
Authors: Ilker Uçkay; Vinoth Yogarasa; Felix W A Waibel; Annette Seiler-Bänziger; Maja Kuhn; Margrit Sahli; Martin C Berli; Benjamin A Lipsky; Madlaina Schöni Journal: J Diabetes Res Date: 2022-08-05 Impact factor: 4.061