Pinargote Héctor, Ramos Jose Manuel, Zurita Alina, Portilla Joaquin
José M. Ramos, Servicio de Medicina Interna. Hospital General Universitario de Alicante. C/ Pintor Baeza, 12, 03010 Alicante, Spain.
Rev Esp Quimioter. 2015 Dec;28(6):310-3.
Pneumonia is a common infectious disease and causes significant morbidity and mortality especially in elderly people. Aspiration as a cause of pneumonia is common in this population. The aim of our study was to describe the clinical features and outcomes of very old patients with aspiration pneumonia (AP) and comparing them with patients with non-AP.
In this prospective cohort study, we analyzed old patients (≥80 years-old) with pneumonia admitted 2014 in the Department of General Internal Medicine.
Seventy-six old patients with pneumonia were included in the study, and 46 (60.5%) met criteria of AP. Increasing levels of urea, creatinine and sodium and low estimated glomerular filtrate rate were more common among AP patients. In addition, severity of pneumonia scored by pneumonia severity index and CURB-65 score were significantly greater in AP than in non-AP patients. The 30-days mortality in AP was (44%) quite higher than in non-AP (32%). The only predictor of mortality was high level of sodium (odds ratio: 1.09; 95% confidence intervals: 1.00-1.18).
AP in octogenarian and nonagenarians showed higher levels of sodium and low estimated glomerular filtrate rate and higher severity of pneumonia and slightly higher mortality than non-AP.
肺炎是一种常见的传染病,尤其在老年人中会导致严重的发病和死亡。误吸作为肺炎的一个病因在该人群中很常见。我们研究的目的是描述高龄误吸性肺炎(AP)患者的临床特征和预后,并将他们与非AP患者进行比较。
在这项前瞻性队列研究中,我们分析了2014年入住普通内科的老年(≥80岁)肺炎患者。
76例老年肺炎患者纳入研究,其中46例(60.5%)符合AP标准。AP患者中尿素、肌酐和钠水平升高以及估计肾小球滤过率降低更为常见。此外,AP患者中用肺炎严重程度指数和CURB-65评分评估的肺炎严重程度显著高于非AP患者。AP患者的30天死亡率(44%)远高于非AP患者(32%)。死亡率的唯一预测因素是高钠水平(比值比:1.09;95%置信区间:1.00 - 1.18)。
八九十岁老人中的AP患者相比于非AP患者表现出更高的钠水平、更低的估计肾小球滤过率、更高的肺炎严重程度以及略高的死亡率。