Background:Age is an established risk factor for poor outcomes in individuals with influenza-related illness, and data on its influence on clinical presentations and outcomes in the South-East Asian settings are scarce. The aim of this study was to determine the above among adults with influenza-related upper respiratory tract infection at a teaching hospital in Malaysia.
Methods:A retrospective case-note analysis was conducted on a cohort of 3935 patients attending primary care at with URTI symptoms. Demographics, clinical characteristics, medical and vaccination history were obtained from electronic medical records, and mortality data from the National Registration Department. Comparisons were made between those aged <25, ≥25 to <65 and ≥65 years.Results: 470 (11.9%) had PCR-confirmed influenza virus infection. Six (1.3%) received prior influenza vaccination. Those aged ≥65 years were more likely to have ≥2 comorbidities (P < .001) and were less likely to present with fever (P = .004). One-third of those aged ≥65 years experienced hospitalization, intensive care admission or death within a year compared to 10% in the ≥25 to <65 years. Age ≥65 years was an independent predictor of hospitalization and death (OR = 9.97; 95% CI = 3.11-31.93) compared to those aged <25 years.
Conclusion:Older patients in our cohort were more likely to have comorbidities and present with atypical features, with older age being an independent predictor of poor health outcomes. Our findings will now inform future health policies on older persons and economic modelling of adult vaccination programmes.
Aim: Research on patient-reported outcomes in colorectal cancer are scarce in Malaysia. We aimed to determine pattern of health-related quality of life and its associations among patients with colorectal cancer.Methods: A cross-sectional study of 324 patients. Data were drawn from patient’s records and interviews. Research tools included the locally validated European Organization for Research and Treatment of Cancer (EORTC) core QLQ-C30 and colorectal-cancer specific QLQ-CR29 questionnaires.Results: The mean (±standard deviation) age of patients was 62.5 (±13.6) years. Majority of them were Chinese (62.3%) followed by Malays (19.8%), Indians (14.8%) and others (3.1%). Colon cancer was 7-fold more common than rectal cancer (87% vs 13%). Majority of them were presented at Stage II (29.6%) and III (28.1) of TNM Staging. The mean (±SD) score for global health status/quality of life (GHS/QOL) was 73.13 (±14.19). Good overall functionality (mean scores ≥80) was observed for physical, emotional, role, cognitive and social/family for QLQ-C30; body image, anxiety and weight for QLQ-CR29. The mean score for sexual functioning in men (32.95±28.81) and women (17.56±25.60) were low. Commonest symptoms were fatigue (22.29±17.40), urinary frequency (21.96 ± 24.22) and insomnia (18.42 ± 23.32). Those with lower GHS/QOL had stoma (p=0.044) and were of Chinese ethnicity (p<0.001). On multivariate analysis, ethnicity was the only independent predictor of GHS/QOL (95% confidence interval, 2.589 to 6.139, p<0.001). Conclusion: Our results suggest that there is decrease in sexual functioning despite good overall GHS/QOL among our colorectal cancer survivors. Fatigue, sleep loss and urinary frequency were the common symptoms after cancer treatment. Chinese patients had the poorest quality of life.
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