Logistic regression

Altered Mental Status

Internal medicine

Psychiatry

Emergency department

Medicine

Odds ratio

Emergency medicine

Observational study

Lethargy

Malaise

Pediatrics

Journal of the American Geriatrics Society

Objectives To determine if nonspecific symptoms and fever affect the posttest probability of acute bacterial infection in older patients in the emergency department (ED). Design Preplanned, secondary analysis of a prospective observational study. Setting Tertiary care, academic ED. Participants A total of 424 patients in the ED, 65 years or older, including all chief complaints. Measurements We identified presence of altered mental status, malaise/lethargy, and fever, as reported by the patient, as documented in the chart, or both. Bacterial infection was adjudicated by agreement among two or more of three expert reviewers. Odds ratios were calculated using univariable logistic regression. Positive and negative likelihood ratios (PLR and NLR, respectively) were used to determine each symptom's effect on posttest probability of infection. Results Of 424 subjects, 77 (18%) had bacterial infection. Accounting for different reporting methods, presence of altered mental status (PLR range, 1.40‐2.53) or malaise/let...

Nonspecific Symptoms Lack Diagnostic Accuracy for Infection in Older Patients in the Emergency Department