Analysis of prognosis in hospitalized elderly patients with pneumonia according to age groups

Abstract

Aim: We aimed to determine the factors that affect prognosis in geriatric hospitalized patients according to age groups with pneumonia by evaluating the clinical, radiological, laboratory paremeters, risk factors and management plan.

Materials and Method: Three hundred and five consecutive patients aged above 65 years hospitalized with the diagnosis of pneumonia were included to the study. Hospital records were scanned retrospectively with regard to laboratory, radiologic findings and treatment protocols. Geriatric patients were assessed and compared in two groups as aged(65-74 years) and elderly (75 years and above).

Results: Of the patients, 137 (57%) were male and 132 (43%) were female. Eighty nine (29%) patients were between 65-74 years and 216 (71%) of them were 75 years and above. Presence of confusion, cyanosis and hypotension were higher and acidosis, hypoxemia were prominent in arterial blood gases in patients who were 75 years and above. CURB65 and pneumonia severity index (PSI) scores were significantly higher in patients with elevated C reactive protein (CRP) values (p =0.016 and p=0.028). Sputum cultures were significantly positive in patients having pneumonia within a year and at least with one risk factor (respectively, p=0.012, p=0.016). Cardiovascular disease (63%), pulmonary disease (36%) and diabetes mellitus (36%) were most frequently seen comorbidities and there was a significant relationship between presence of chronic obstructive pulmonary disease (COPD) and need for intensive care unit (p=0.001). Mortality rate was 5,24% and comorbidities were higher in those patients.

Conclusion: In aged and elderly patients with pneumonia,presence of COPD is found to be the most determining comorbid disease associated with the need for intensive care unit. Inpatient treatment makes close follow up, determination of responsible pathogens and rational antibiotic use possible.