Community-acquired pneumonia requiring hospitalization in the elderly. Clinical features and prognosis

We evaluated retrospectively 96 patients older than 64 years admitted with the diagnosis of Community Acquired Pneumonia (CAP) in order to describe the clinical features, evaluate severity and assess prognostic factors. During an 18-month period 100 cases of CAP were included. Average age was 82.3 y...

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Detalles Bibliográficos
Publicado: 1999
Materias:
Elderly
Mortality
Pneumonia
Prognosis
Severity
aged
Argentina
article
bacterial pneumonia
communicable disease
female
hospitalization
human
male
mortality
multivariate analysis
prognosis
retrospective study
Aged
Aged, 80 and over
Community-Acquired Infections
Female
Hospital Mortality
Hospitalization
Humans
Male
Multivariate Analysis
Pneumonia, Bacterial
Retrospective Studies
Severity of Illness Index
Acceso en línea:https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_00257680_v59_n6_p731_Fuenzalida
http://hdl.handle.net/20.500.12110/paper_00257680_v59_n6_p731_Fuenzalida
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Biblioteca Digital - Facultad de Ciencias Exactas y Naturales (UBA) de Universidad de Buenos Aires
id paper:paper_00257680_v59_n6_p731_Fuenzalida
record_format dspace
spelling paper:paper_00257680_v59_n6_p731_Fuenzalida2023-06-08T14:53:33Z Community-acquired pneumonia requiring hospitalization in the elderly. Clinical features and prognosis Elderly Mortality Pneumonia Prognosis Severity aged Argentina article bacterial pneumonia communicable disease female hospitalization human male mortality multivariate analysis prognosis retrospective study Aged Aged, 80 and over Argentina Community-Acquired Infections Female Hospital Mortality Hospitalization Humans Male Multivariate Analysis Pneumonia, Bacterial Prognosis Retrospective Studies Severity of Illness Index We evaluated retrospectively 96 patients older than 64 years admitted with the diagnosis of Community Acquired Pneumonia (CAP) in order to describe the clinical features, evaluate severity and assess prognostic factors. During an 18-month period 100 cases of CAP were included. Average age was 82.3 years ± 8.3 (± SD). By the time of admission, cough and fever were found in 35% of cases and 48% had altered mental status. Fourteen per cent needed mechanical ventilation. Etiology was determined in 21% of cases. Most common pathogens were S. pneumoniae (38.1%), S. aureus (19%) and H. infuenzae (14.3%). Overall mortality was 29%. The most commonly present criteria of severity were tachypnea (respiratory rate > 30) and a PaO2,/FIO2 ratio < 250. Severe pneumonia was found in 60% of patients and mortality in that group was 40%. Multivariate analysis demonstrated that some independent prognostic factors were associated with higher mortality: requirement of vasopressors (Odds Ratio [OR] = 22.0; 95% confidence interval [Cl] = 1.9-249.5), oliguria (OR = 9.9; Cl = 1.5-66.2), previous neurologic disease (OR = 8.2; Cl = 1.8-36.6), PaCO2 > 44 mm/Hg (OR = 6.9; Cl = 1.1-43.2), and creatinine > 1.4 mg/dl (OR = 4.7; Cl = 1.2-19.1). We conclude that CAP features in elderly patients requiring hospitalization are atypical, severe presentations are frequent and mortality is high. Prognostic factors as found in this study can help the evaluating physician to identify those who require special care. 1999 https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_00257680_v59_n6_p731_Fuenzalida http://hdl.handle.net/20.500.12110/paper_00257680_v59_n6_p731_Fuenzalida
institution Universidad de Buenos Aires
institution_str I-28
repository_str R-134
collection Biblioteca Digital - Facultad de Ciencias Exactas y Naturales (UBA)
topic Elderly
Mortality
Pneumonia
Prognosis
Severity
aged
Argentina
article
bacterial pneumonia
communicable disease
female
hospitalization
human
male
mortality
multivariate analysis
prognosis
retrospective study
Aged
Aged, 80 and over
Argentina
Community-Acquired Infections
Female
Hospital Mortality
Hospitalization
Humans
Male
Multivariate Analysis
Pneumonia, Bacterial
Prognosis
Retrospective Studies
Severity of Illness Index
spellingShingle Elderly
Mortality
Pneumonia
Prognosis
Severity
aged
Argentina
article
bacterial pneumonia
communicable disease
female
hospitalization
human
male
mortality
multivariate analysis
prognosis
retrospective study
Aged
Aged, 80 and over
Argentina
Community-Acquired Infections
Female
Hospital Mortality
Hospitalization
Humans
Male
Multivariate Analysis
Pneumonia, Bacterial
Prognosis
Retrospective Studies
Severity of Illness Index
Community-acquired pneumonia requiring hospitalization in the elderly. Clinical features and prognosis
topic_facet Elderly
Mortality
Pneumonia
Prognosis
Severity
aged
Argentina
article
bacterial pneumonia
communicable disease
female
hospitalization
human
male
mortality
multivariate analysis
prognosis
retrospective study
Aged
Aged, 80 and over
Argentina
Community-Acquired Infections
Female
Hospital Mortality
Hospitalization
Humans
Male
Multivariate Analysis
Pneumonia, Bacterial
Prognosis
Retrospective Studies
Severity of Illness Index
description We evaluated retrospectively 96 patients older than 64 years admitted with the diagnosis of Community Acquired Pneumonia (CAP) in order to describe the clinical features, evaluate severity and assess prognostic factors. During an 18-month period 100 cases of CAP were included. Average age was 82.3 years ± 8.3 (± SD). By the time of admission, cough and fever were found in 35% of cases and 48% had altered mental status. Fourteen per cent needed mechanical ventilation. Etiology was determined in 21% of cases. Most common pathogens were S. pneumoniae (38.1%), S. aureus (19%) and H. infuenzae (14.3%). Overall mortality was 29%. The most commonly present criteria of severity were tachypnea (respiratory rate > 30) and a PaO2,/FIO2 ratio < 250. Severe pneumonia was found in 60% of patients and mortality in that group was 40%. Multivariate analysis demonstrated that some independent prognostic factors were associated with higher mortality: requirement of vasopressors (Odds Ratio [OR] = 22.0; 95% confidence interval [Cl] = 1.9-249.5), oliguria (OR = 9.9; Cl = 1.5-66.2), previous neurologic disease (OR = 8.2; Cl = 1.8-36.6), PaCO2 > 44 mm/Hg (OR = 6.9; Cl = 1.1-43.2), and creatinine > 1.4 mg/dl (OR = 4.7; Cl = 1.2-19.1). We conclude that CAP features in elderly patients requiring hospitalization are atypical, severe presentations are frequent and mortality is high. Prognostic factors as found in this study can help the evaluating physician to identify those who require special care.
title Community-acquired pneumonia requiring hospitalization in the elderly. Clinical features and prognosis
title_short Community-acquired pneumonia requiring hospitalization in the elderly. Clinical features and prognosis
title_full Community-acquired pneumonia requiring hospitalization in the elderly. Clinical features and prognosis
title_fullStr Community-acquired pneumonia requiring hospitalization in the elderly. Clinical features and prognosis
title_full_unstemmed Community-acquired pneumonia requiring hospitalization in the elderly. Clinical features and prognosis
title_sort community-acquired pneumonia requiring hospitalization in the elderly. clinical features and prognosis
publishDate 1999
url https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_00257680_v59_n6_p731_Fuenzalida
http://hdl.handle.net/20.500.12110/paper_00257680_v59_n6_p731_Fuenzalida
_version_ 1768544029303111680

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