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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| Acceso en línea: | http://hdl.handle.net/20.500.12110/paper_00257680_v59_n6_p731_Fuenzalida |
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todo:paper_00257680_v59_n6_p731_Fuenzalida2023-10-03T14:36:36Z Community-acquired pneumonia requiring hospitalization in the elderly. Clinical features and prognosis Fuenzalida, A.D. Vera, C. Santamarina, J. Izarduy, L. Bagnasco, R. Grinspon, S. Khoury, M. Rodriguez, C.H. Luna, C.M. 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. JOUR info:eu-repo/semantics/openAccess http://creativecommons.org/licenses/by/2.5/ar 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 |
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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 Fuenzalida, A.D. Vera, C. Santamarina, J. Izarduy, L. Bagnasco, R. Grinspon, S. Khoury, M. Rodriguez, C.H. Luna, C.M. 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. |
| format |
JOUR |
| author |
Fuenzalida, A.D. Vera, C. Santamarina, J. Izarduy, L. Bagnasco, R. Grinspon, S. Khoury, M. Rodriguez, C.H. Luna, C.M. |
| author_facet |
Fuenzalida, A.D. Vera, C. Santamarina, J. Izarduy, L. Bagnasco, R. Grinspon, S. Khoury, M. Rodriguez, C.H. Luna, C.M. |
| author_sort |
Fuenzalida, A.D. |
| 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 |
| url |
http://hdl.handle.net/20.500.12110/paper_00257680_v59_n6_p731_Fuenzalida |
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