Esposito A L
Arch Intern Med. 1984 May;144(5):945-8.
The cases of 38 hospitalized adults with community-acquired bacteremic pneumococcal pneumonia were evaluated prospectively to identify age-related differences in presenting features, clinical course, and outcome. Ten of 18 elderly patients (older than 65 years) were admitted from chronic care institutions v one of 20 younger adults. Coronary artery disease was more prevalent among the aged patients, and alcohol abuse and cigarette smoking were more common among the younger patients. All of the elderly persons and 90% of the younger had at least one serious underlying disorder. Older patients tended to report rigors and pleuritic chest pain less frequently than did the younger. Azotemia and roentgenographic evidence of multiple-lobe involvement were found more commonly in elderly persons. However, age-associated discrepancies were not observed in the duration of symptoms before admission, the prevalence of respiratory failure or metastatic infection, the interval between presentation and antibiotic administration, the duration of fever, the length of hospitalization, or the case fatality rates. Thus, the effects of advanced age on the manifestations and clinical course of community-acquired bacteremic pneumococcal pneumonia appear less pronounced than has been reported previously.
对38例住院的社区获得性菌血症性肺炎成年患者进行前瞻性评估，以确定其在临床表现、临床病程和转归方面与年龄相关的差异。18例老年患者（年龄大于65岁）中有10例来自长期护理机构，而20例年轻患者中仅有1例。老年患者中冠状动脉疾病更为常见，而年轻患者中酗酒和吸烟更为普遍。所有老年患者和90%的年轻患者都至少有一种严重的基础疾病。老年患者寒战和胸膜炎性胸痛的报告频率往往低于年轻患者。氮质血症和多叶受累的影像学证据在老年人中更为常见。然而，在入院前症状持续时间、呼吸衰竭或转移性感染的患病率、就诊与使用抗生素之间的间隔、发热持续时间、住院时间或病死率方面未观察到与年龄相关的差异。因此，高龄对社区获得性菌血症性肺炎的表现和临床病程的影响似乎不如先前报道的那么明显。
