When compared with younger patients, adults older than 65 years hospitalized for nonlocalizing fever or acute respiratory illness were less likely to undergo provider-ordered influenza tests, according to findings published in the Journal of the American Geriatrics Society.
“A better understanding of the factors involved in provider-ordered testing is needed to determine the barriers to early identification and treatment of infection,” Lauren M. Hartman MD, of the department of medicine at Vanderbilt University School of Medicine, and colleagues wrote.
Researchers conducted their study on 1,422 patients aged 18 years and older with nonlocalizing fever or acute respiratory illness at four hospitals in Tennessee.
Hartman and colleagues found that 28% of patients had provider-ordered influenza testing. Those who underwent tests were younger than those who were not tested (mean age, 58 ± 18 years vs. 66 ± 15 years; P < .001) and more likely to have influenza-like illness (71% vs. 49%; P < .001).
Researchers also wrote that younger age and having an influenza-like illness were independent predictors of provider-ordered testing. In the 136 patients with influenza validated by reverse-transcriptase polymerase chain reaction tests, only influenza-like illness was a significant predictor of provider-ordered testing (adjusted OR = 3.43; 95% CI, 1.22-9.7).
“No single factor accounts for decreased provider-ordered testing in [the older adult] population, though differences in presentation including less influenza-like illness, attenuation of symptoms by vaccination, and higher burden of underlying cardiac and pulmonary disease may impact the decision of the provider to perform influenza testing,” Hartman and colleagues wrote. “Further strategies are needed to increase clinician understanding of the challenges in clinically identifying influenza in older adults, as well as the limitations of diagnostic tests, to better diagnose and treat cases of influenza in this vulnerable population.” – by Janel Miller
Hartman reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.