目的:日本老年医疗机构的老年居民发生感染性腹泻的风险尚不清楚。我们调查了此类设施中诺如病毒相关性腹泻的发生率和危险因素。
方法:这项前瞻性队列研究追踪了2018年11月至2020年4月在大阪10个老年中间护理机构的1727名居民,日本关于腹泻的发生。居民数据是在以下三个时间点中的两到三个时间点使用结构化表格从他们的医疗记录中收集的:如果他们出现腹泻,当他们离开设施时。患有腹泻的居民使用诺如病毒的快速诊断测试进行了测试。Cox比例风险模型用于风险比(HRs)和95%置信区间(CI),以估计诺如病毒相关性腹泻的危险因素。
结果:在研究期间,74名居民出现腹泻,其中13名诺如病毒阳性。诺如病毒相关性腹泻的发生率为10.11/1000人年(95%CI:4.61-15.61)。在风险因素方面,护理需求为3级的人群发生诺如病毒相关性腹泻的风险较高(校正后HR[aHR]=7.35,95%CI:1.45~37.30).高血压(aHR=3.41,95%CI:1.05-11.04)或中风(aHR=8.84,95%CI:2.46-31.83)的居民,那些手杖行走的人(aHR=16.68,95%CI:1.35-206.52)患诺如病毒相关性腹泻的风险也显著较高.
结论:在整个研究期间,腹泻的发生率较低。护理需求3级,中风,在日本老年中级护理机构中,高血压和使用甘蔗被确定为诺如病毒相关性腹泻的危险因素.GeriatrGerontolInt2023;••:••-•。
OBJECTIVE: The risk of developing infectious diarrhea among elderly residents at Japanese geriatric intermediate care facilities is unclear. We investigated the incidence rate and risk factors of norovirus-related diarrhea at such facilities.
METHODS: This prospective cohort study followed 1727 residents from November 2018 to April 2020 at 10 geriatric intermediate care facilities in Osaka, Japan regarding the occurrence of diarrhea. Resident data were collected from their medical records using structured forms at two to three of the following three time points: at recruitment, if they developed diarrhea, and when they left the facility. Residents who developed diarrhea were tested using rapid diagnostic tests for norovirus. Cox proportional hazard model was employed to hazard ratios (HRs) with 95% confidence intervals (CIs) to estimate the risk factors for norovirus-related diarrhea.
RESULTS: During the study period, 74 residents developed diarrhea, 13 of whom were norovirus positive. The incidence rate of norovirus-related diarrhea was 10.11 per 1000 person-years (95% CI: 4.61-15.61). In terms of risk factors, people with care-needs level 3 were at a higher risk for developing norovirus-related diarrhea (adjusted HR [aHR] = 7.35, 95% CI: 1.45-37.30). Residents with hypertension (aHR = 3.41, 95% CI: 1.05-11.04) or stroke (aHR = 8.84, 95% CI: 2.46-31.83), and those who walked with canes (aHR = 16.68, 95% CI: 1.35-206.52) also had a significantly higher risk for norovirus-related diarrhea.
CONCLUSIONS: Throughout the study period, the incidence of development of diarrhea was low. Care-needs level 3, stroke, hypertension and use of a cane were identified as risk factors for norovirus-related diarrhea in Japanese geriatric intermediate care facilities. Geriatr Gerontol Int 2023; 23: 179-187.