Frohnhofen Helmut, Stieglitz Sven
Fakultät für Gesundheit Department Humanmedizin, Universität Witten-Herdecke, Alfred-Herrhausen-Str. 50, 58448 Witten, Deutschland.
Universitätklinikum Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Deutschland.
Pneumologe (Berl). 2021;18(3):174-181. doi: 10.1007/s10405-021-00388-z. Epub 2021 Mar 16.
Pneumonia is a common and severe disease in older people. In this group of patients pneumonia is among the four most frequent diseases leading to death. The diagnosis can often be difficult due to an atypical clinical presentation. Therefore, pneumonia should always be considered as the cause of any deterioration in an older person. Geriatric problems, such as frailty, physical and psychological limitations should be recorded as well as the social situation, as all these factors are of prognostic importance. Pneumonia acquired in a nursing home or by people in need of long-term care has a less favorable prognosis. Although this type of pneumonia is considered to be community acquired, special attenion is required. The treatment of pneumonia does not fundamentally differ from the treatment of younger patients but should take special situations into account, such as the patient's wishes documented in a living will when planning therapy. Older people in particular often show atypical clinical pictures with a coronavirus disease 2019 (COVID-19) infection. Therefore, in any acute change in the health condition of an older person COVID-19 should be considered.
肺炎在老年人中是一种常见且严重的疾病。在这组患者中，肺炎是导致死亡的四大常见疾病之一。由于临床表现不典型，诊断往往很困难。因此，肺炎应始终被视为老年人病情恶化的原因。应记录老年问题，如虚弱、身体和心理限制以及社会状况，因为所有这些因素都具有预后意义。在养老院或需要长期护理的人群中获得的肺炎预后较差。尽管这种类型的肺炎被认为是社区获得性的，但仍需要特别关注。肺炎的治疗与年轻患者的治疗在根本上没有区别，但在规划治疗时应考虑特殊情况，例如患者在生前遗嘱中记录的意愿。特别是老年人感染2019冠状病毒病（COVID-19）时往往表现出非典型的临床症状。因此，在老年人健康状况出现任何急性变化时，都应考虑COVID-19。
