Clinical features and prognostic factors of elderly patients with severe community-acquired pneumonia

Abstract

Objective To investigate clinical features and prognostic factors of the elderly patients with severe community-acquired pneumonia (SCAP) . Methods We retrospectively analyzed 46 elderly and 22 non-elderly inpatients with SCAP from 2008 to 2014 in Jishuitan Hospital. Then we studied clinical features of elderly patients with SCAP, and compared the differences on factors such as demography, clinic, treatment, etc. by using logistic regression analysis. Results Compared with non-elderly group, the elderly SCAP group usually had basic chronic diseases, faster respiratory rate (≥30 times/min) , low blood pressure, consciousness change, higher blood urea nitrogen and creatinine, longer hospital day and higher mortality rate (P all <0.05) . Among the 46 elderly patients with SCAP, univariate analysis showed that the death group who had the incidence of CAP disease history within last one year, body temperature<36 ℃ and structural lung disease, septic shock were higher than survival group (P<0.05 or P<0.01) ; while for those who had had antimicrobial therapy, de-escalation antibiotic therapy and β-lactam antibiotics plus macrolide, the death group was lower than the survival group (P<0.01) . Logistic regressesion analysis showed that septic shock (OR=36.173, 95%CI:4.190-312.277) and combined antimicrobial therapy (OR=0.017, 95%CI: 0.0021-0.225) were independent prognostic factors. Conclusions The clinical features are different between elderly SCAP and no-elrderly SCAP patients. Septic shock is one of the SCAP prognostic risk factors, and initially combine antimicrobial therapy is one of protective factor helping reduce the mortality. Key words: Pneumpnia; Clinical features; Prognostic factors; Elderly patients