• Min-Hsien Chung, Feng-Yuan Chu, Tzu-Meng Yang, Hung-Jung Lin, Jiann-Hwa Chen, How-Ran Guo, Si-Chon Vong, Shih-Bin Su, Chien-Cheng Huang, and Chien-Chin Hsu.
• Department of Emergency Medicine, Chi-Mei Medical Center, Tainan, Taiwan.
• Geriatr Gerontol Int. 2015 Jul 1; 15 (7): 834-9.

AimThe geriatric population (aged ≥65 years) accounts for 12-24% of all emergency department (ED) visits. Of them, 10% have a fever, 70-90% will be admitted and 7-10% of will die within a month. Therefore, mortality prediction and appropriate disposition after ED treatment are of great concern for geriatric patients with fever. We tried to identify independent mortality predictors of geriatric patients with fever, and combine these predictors to predict their mortality.MethodsWe enrolled consecutive geriatric patients visiting the ED between 1 June and 21 July 2010 with the following criteria of fever: a tympanic temperature ≥37.2°C or a baseline temperature elevated ≥1.3°C. We used 30-day mortality as the primary end-point.ResultsA total of 330 patients were enrolled. Hypotension, bedridden, leukocytosis, thrombocytopenia and serum creatinine >2 mg/dL, but not age, were independently associated with 30-day mortality. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) ranged from 18.2% to 90.9%, 34.7% to 100%, 9.0% to 100% and 94.5% to 98.2%, respectively, depending on how many predictors there were.ConclusionsThe 30-day mortality increased with the number of independent mortality predictors. With at least four predictors, 100% of the patients died within 30 days. With none of the predictors, just 1.8% died. These findings might help physicians make decisions about geriatric patients with fever.© 2014 Japan Geriatrics Society.

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