Trager Institute.
Department of Family and Geriatric Medicine, School of Medicine, University of Louisville.
Curr Opin Infect Dis. 2021 Apr 1;34(2):135-141. doi: 10.1097/QCO.0000000000000718.
The purpose of this review is to address the relevant issues surrounding older adults with community-acquired pneumonia (CAP) today.
Approximately 1 million people >65 years have CAP in the US per year, which is more than previously reported (or realized). Older adults are vulnerable to the increasing prevalence of viral CAP, as the SARS-CoV-2 pandemic emphasizes, but pneumococcus is still the most common pathogen to cause CAP. Racial disparities continue to need to be addressed in order to improve early and late outcomes of older adults with CAP.
The epidemiology of CAP, specifically for older adults is changing. More recent pathogen incidence studies have included culture, as well as newer microbiological methods to determine etiology. Current disparities among disadvantaged populations, including African-Americans, result in more comorbidities which predisposes to more severe CAP. However, outcomes in the hospital between races tend to be similar, and outcomes between age groups tends to be worse for older compared to younger adults. Finally, the cost of CAP is significant compared to diabetes mellitus, myocardial infarction and stroke.
本文旨在讨论当今社区获得性肺炎（CAP）老年患者的相关问题。
每年约有 100 万 65 岁以上的美国人患有 CAP，这比之前报告的（或意识到的）要多。如 SARS-CoV-2 大流行所强调的那样，老年人易感染日益流行的病毒性 CAP，但肺炎球菌仍然是导致 CAP 的最常见病原体。为了改善 CAP 老年患者的早期和晚期结局，仍需解决种族差异问题。
CAP 的流行病学，特别是针对老年人的情况正在发生变化。最近的病原体发病率研究包括培养以及确定病因的新微生物学方法。包括非裔美国人在内的弱势群体中目前仍然存在着各种差异，这些差异导致更多的合并症，从而更容易导致更严重的 CAP。然而，不同种族间的住院结局往往相似，且与年轻患者相比，老年患者的结局往往更差。最后，CAP 的治疗费用与糖尿病、心肌梗死和中风相当。
