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Erkennen von Infektionen beim älteren Notfallpatienten

Recognition of infections in elderly emergency patients

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Zusammenfassung

Hintergrund

Notaufnahmen werden zunehmend mit multimorbiden und komplex zu versorgenden älteren Patienten konfrontiert. Infektionen stellen eine der Haupttodesursachen der älteren Patienten, die sich in einer Notaufnahme vorstellen, dar. Sie sind aber häufig nur schwierig bei den betroffenen Patienten zu diagnostizieren.

Ziel der Arbeit

Die vorliegende Arbeit bietet eine Übersicht über wichtige Befundkonstellationen und Möglichkeiten/Limitierungen der Diagnostik von Infektionen bei älteren Patienten.

Material und Methode

Hierzu wurde eine selektive Literaturrecherche in PubMed im Zeitraum zwischen 1990 und 2015 durchgeführt. Ergänzend werden eigene Daten vorgestellt.

Ergebnisse und Schlussfolgerung

Infektionen älterer Notfallpatienten präsentieren sich häufig atypisch; daher ist es notwendig, auch subtile Veränderungen zu berücksichtigen. Zur Diagnosestellung einer akuten Infektion sind unspezifische Symptome, Vitalparameter, Laborwerte (einschließlich Infektionsmarker wie C-reaktives Protein oder Prokalzitonin), der kognitive Status und die Funktionalität des Patienten zu berücksichtigen.

Abstract

Background

Elderly patients represent an increasing population in the emergency department (ED) and physicians often have to deal with multimorbidity and complexity. Infections are one of the major reasons for ED presentations of older patients and the main cause of mortality; however, infections are often difficult to diagnose in older patients.

Aim

This article provides a review of important indicators for infections, diagnostic tools and limitations in elderly patients.

Material and methods

A literature search was carried out using PubMed in the period 1990–2015 and in addition own published data are presented.

Results and conclusion

Infections in the elderly are difficult to assess in the emergency department due to atypical symptoms. Even subtle changes need to be recognized. For the diagnosis of infections in older ED patients unspecific symptoms, vital parameters, laboratory parameters, including C-reactive protein (CRP) and procalcitonin levels, cognitive function and functionality of the patient need to be taken into account.

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Authors and Affiliations

  1. Klinik für Kardiologie und Angiologie I, Universitäts-Herzzentrum Freiburg, Freiburg, Deutschland

    M. Hortmann

  2. Institut für Biomedizin des Alterns, Klinik für Geriatrie, Klinikum Nürnberg, Friedrich-Alexander Universität Erlangen-Nürnberg, Nürnberg, Deutschland

    K. Singler

  3. Universitätsklinik für Notfallmedizin und Internistische Intensivmedizin, Paracelsus Medizinische Privatuniversität, Prof. Ernst Nathan Str. 1, 90419, Nürnberg, Deutschland

    F. Geier &  M. Christ M.D.

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  1. M. Hortmann
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  3. F. Geier
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  4. M. Christ M.D.
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Correspondence to M. Christ M.D..

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M. Hortmann, K. Singler, F. Geier und M. Christ geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Hortmann, M., Singler, K., Geier, F. et al. Erkennen von Infektionen beim älteren Notfallpatienten. Z Gerontol Geriat 48, 601–607 (2015). https://doi.org/10.1007/s00391-015-0903-2

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  • DOI: https://doi.org/10.1007/s00391-015-0903-2

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