Pneumonia In Elderly Patients Research Articles

Antibiotic prescriptions for COVID-19 patients increased during the BA.5 period

The initial omicron (B.1.1.529) severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) subvariants, BA.1 and BA.2 (BA.1/2), were progressively displaced by BA.5 in Japan, which showed not only higher transmittivity and less pathogenicity, but also differences in antibiotic use according to the difference in the clinical course of BA.5 compared with BA.1/2 infections. BA.5 patients received more antibiotics, especially ampicillin/sulbactam, although ceftriaxone and meropenem were used significantly in the BA.1/2 period. These data suggest an increased incidence of aspiration pneumonia in elderly patients in the BA.5 period, and we should consider changing the management tactics for COVID-19.

Severe COVID-19 Pneumonia in Elderly Patients: Success Rate of Compassioned Use of High Flow Nasal Cannula Therapy.

Severe COVID-19 Pneumonia in Elderly Patients: Success Rate of Compassioned Use of High Flow Nasal Cannula Therapy.

Association of orthodontic treatment and aspiration pneumonia

Foreign body aspiration or ingestion is an uncommon potential complication during orthodontic dentistry, and it can produce a medical emergency. Obstruction of the airways can be life-threatening, and delayed recognition and management can result in pulmonary complications such as recurrent pneumonia. Dental treatment has been identified as an important cause of the misplacement of foreign bodies in the airway. Objects used in orthodontic treatment are mainly used due to their manufacturing limitations, such as their shape and size, and because they are made of radiolucent materials, which make them easy to aspirate or ingest and difficult to detect with a radiograph. However, few reports have been published on orthodontic dentistry-related foreign body aspiration and pulmonary complications. Furthermore, micro-aspiration due to poor oral hygiene in patients undergoing orthodontic procedures has been investigated in this review since poor oral hygiene is a well-established risk factor for aspiration pneumonia in the elderly population. The association between the aspiration of orthodontic material and aspiration pneumonia is not well established. Aspiration pneumonia is a secondary symptom of misdiagnosis or delayed diagnosis of dental material aspiration. Additionally, poor oral hygiene can also increase the risk of aspiration pneumonia in elderly patients since poor oral hygiene during orthodontic treatment leads to plaque retention, which can lead to increased development of hyperplastic gingivitis and periodontal breakdown, established risk factor for aspiration pneumonia.

Medication Appropriateness in Elderly Patients Diagnosed with Pneumonia

Ageing is a natural process accompanied with compromised good health. Pneumonia is associated with several independent risk factors, including the severity of clinical presentation, age, comorbidities, and specific pathogens which increase the burden of morbidity, mortality in aged patients. This study was carried out to assess the appropriateness of therapy for pneumonia in elderly patients. A prospective, observational study was conducted from July 2018 to June 2021 in the department of pulmonary medicine of a tertiary care teaching hospital in Bangalore, India. A total of 90 elderly patients aged >65 years, diagnosed with pneumonia who fulfilled study criteria and consented to take part in the study were enrolled. A well designed and internally validated case report form was used to document the findings after a due approval from the Institutional Ethics Committee. Socio-demographic characteristics, prescribed medications and clinical characteristics were documented and analyzed. Out of the 90 elderly patients, 25.6% were male while 75.4% were female. The mean age of the participants was 70.03±5.26 (SD) years. Applying tools like START/STOPP criteria, Beers criteria and MAI index, it was found that, 16.7% were received incorrect dose, 12.22% received drug duplication, 3.3% received drug which was not indicated, 2.2% received drug which was not effective for that condition and in 1.1% patients did not receive drugs for required duration. The findings from this study provide the feedback to the healthcare team to ensure rational management of pneumonia in elderly patients and enable this vulnerable population with improved health related quality of life.

Is rehabilitation effective in preventing decreased functional status after community-acquired pneumonia in elderly patients? Results from a multicentre, retrospective observational study

ObjectivesThis study was designed to evaluate the effect of rehabilitation in preventing decreased functional status (FS) after community-acquired pneumonia (CAP) in elderly patients.DesignThis was a retrospective observational study.SettingMulticentre study was...

Determination of risk factors of postoperative pneumonia in elderly patients with hip fracture: What can we do?

BackgroundPostoperative pneumonia is a serious complication in elderly patients with hip fracture. It is necessary to identify the influencing factors of postoperative pneumonia in patients with hip fracture.MethodsElderly patients with hip fractures admitted to a tertiary hospital in China from January 1, 2020 to August 31, 2021 were included. The characteristics of patients with and without postoperative pneumonia were evaluated and compared. Logistic multivariate regression analyses were conducted to assess the risk factors of postoperative pneumonia.Results267 patients with hip fracture were included, the incidence of postoperative pneumonia in patients with hip fracture was 13.11%. There were significant differences in the age, diabetes mellitus, anemia, hypoalbuminemia, anesthesia method and duration of surgery between infection and no infection group, no significant differences in the gender, BMI, hypertension, hyperlipidemia, type of fracture, preoperative oxygen saturation, white blood cell count, platelet count, red blood cell count, creatinine, alanine aminotransferase, aspartate aminotransferase, estimated blood loss during surgery were detected between infection and no infection group. Logistic regression analysis showed that age≥70y (OR2.326, 95%CI1.248~3.129), diabetes mellitus (OR2.123, 95%CI1.021~3.551), anemia (OR3.199,95%CI1.943~5.024), hypoalbuminemia (OR2.377, 95%CI1.211~3.398), general anesthesia (OR1.947, 95%CI1.115~3.038), duration of surgery≥120min (OR1.621, 95%CI1.488~2.534) were the risk factors of postoperative pneumonia in elderly patients with hip fracture (all p<0.05). Escherichia Coli (33.33%), Klebsiella pneumoniae (28.57%), Staphylococcus aureus (21.43%) were the most common bacteria of pulmonary infection.ConclusionThere are many risk factors for postoperative pneumonia in elderly patients with hip fractures after surgery. In clinical practice, medical workers should take targeted interventions for those risk factors to reduce postoperative pneumonia.

Implementation of a pneumonia prevention protocol to decrease the incidence of postoperative pneumonia in patients after hip fracture surgery

ObjectivePostoperative pneumonia is among the most common complications in elderly patients after hip fracture surgery. We implemented a proactive postoperative pneumonia prevention protocol and analyzed the incidence of postoperative pneumonia in elderly patients (≥70 years of age) receiving this protocol after hip fracture surgery versus those receiving usual care before the protocol's implementation at our institution. Materials and MethodsFrom November 2018 to October 2019, the proactive postoperative pneumonia prevention protocol was implemented. The treatment included intensified physical therapy, postoperative pulmonary exercises and oral care, in addition to the usual surgical treatment for elderly patients with hip fracture. The intervention cohort data were compared with a historical control cohort treated from July 2017 to June 2018. The primary outcome of this study was the incidence of postoperative pneumonia in both groups, diagnosed according to the presence of two of three of the following: elevated infection parameters, radiologic examination confirmation of pneumonia of the chest or clinical suspicion. ResultsA total of 494 patients (n= 249 in the historical control cohort and n=245 in the intervention cohort) were included. A total of 69 patients developed postoperative pneumonia. The incidence of postoperative pneumonia was significantly lower (6.7 percentage points) in the group receiving the proactive postoperative pneumonia prevention protocol (17.3% in the historical control cohort vs 10.6% in the intervention cohort; p=0.033). Discussion and ConclusionA proactive postoperative pneumonia prevention protocol showed promise in decreasing the occurrence of postoperative pneumonia after hip fracture surgery in elderly patients.

Long-term postoperative pneumonia in elderly patients with early gastric cancer

BackgroundPneumonia is a major cause of death in the elderly population. Considering body weight loss, muscle loss, and reflux after gastrectomy, elderly patients are considered to be at very high risk for pneumonia, which could decrease overall survival because early gastric cancer is mostly curable only by surgery. We aimed to clarify the incidence of pneumonia in the long-term period after gastrectomy in elderly patients who were diagnosed with early gastric cancer and its risk factors.MethodsWe retrospectively examined patients of > 75 years of age who underwent R0 gastrectomy for gastric cancer and who were diagnosed with T1 disease at National Cancer Center Hospital between 2005 and 2012. Long-term postoperative pneumonia was diagnosed by chest computed tomography every year until 2 years after surgery. The presence of preoperative sarcopenia was assessed using preoperative L3 skeletal muscle index.Results167 patients were included in this study. Long-term postoperative pneumonia was observed in 44 (26%) patients. Of the 44 people diagnosed with long-term postoperative pneumonia, 33 were diagnosed in the 1st year and 11 in the 2nd year. 117 patients (70%) were diagnosed with sarcopenia which was significantly frequently found in the patients who developed long-term postoperative pneumonia (91%) than those without (63%). Preoperative sarcopenia was the only independent risk factor in multivariate analysis. Type of gastrectomy was not a significant risk factor.ConclusionsLong-term postoperative pneumonia was frequently observed in the elderly patients. Preoperative sarcopenia was associated with long-term postoperative pneumonia in elderly patients who underwent curative surgery for gastric cancer. After gastrectomy, long-term special care would be required for elderly patients, especially with sarcopenia.

Analysis of influencing factors of community-acquired pneumonia with deep venous thrombosis in elderly communities

Community-acquired pneumonia (CAP) is one of the common infectious diseases that threaten human health, venous thromboembolism (VTE), including deep venous thrombosis (DVT) and pulmonary thromboembolism (PTE), is a global health care problem. Acute infection and age ≥70 years are important risk factors for VTE in internal medicine inpatients. There is increasing evidence that acute infectious diseases caused by bacterial and viral infections can induce coagulation, platelet (PLT) activation and inhibit the activity of anticoagulant factors. However, there is no consensus on whether patients with CAP suffer from DVT. Finding out the clinical characteristics and risk factors of DVT in elderly patients with CAP is helpful for early identification of high-risk patients with VTE and timely prevention, which can significantly reduce the occurrence of VTE in hospitals. Data was collected from 505 patients with CAP aged ≥70 years old hospitalized in the Department of Respiratory and Critical Care Medicine. 133 patients with DVT were selected as the DVT group. DVT score and risk grading were performed for all patients using Padua. Fifty-seven cases were diagnosed as having severe pneumonia, including 50 cases diagnosed as having septic shock. Padua, D-dimer, between the DVT group and the control group, the severe pneumonia group and the non-severe pneumonia group, and the severe pneumonia DVT group and the control group were compared. (I) The incidence of DVT with severe pneumonia was much higher than with non-severe pneumonia (P<0.001). The incidence of DVT in patients with septic shock and non-septic shock was 74.0% (37/50) and 28.6% (2/7) respectively (P=0.0154). (II) There were significant differences in Padua scores between the DVT group and the control group and between the severe pneumonia group and non-severe pneumonia group (P<0.001). (III) There were significant differences in D-dimer level between the DVT group and the control group and between the severe pneumonia group and the non-severe pneumonia group (P<0.001). (IV) Regression analysis indicated the central venous catheter (CVC), D-dimer value, and Padua score were significantly correlated with thrombosis (P=0.042, <0.001, 0.043). Severe pneumonia in elderly patients and septic shock may be complicated by DVT, and central venous catheterization and D-dimer are closely related to thrombosis.

Relationship Between Preoperative Hypoalbuminemia and Postoperative Pneumonia Following Geriatric Hip Fracture Surgery: A Propensity-Score Matched and Conditional Logistic Regression Analysis.

BackgroundPneumonia is a devastating complication following geriatric hip fracture surgery, and preoperative hypoalbuminemia may be a potentially modifiable factor leading to improved outcome. This study aimed to quantify the relationship between preoperative hypoalbuminemia and postoperative pneumonia.MethodsWe retrospectively reviewed the medical records of elderly patients (≥60 years) who underwent surgeries for hip fracture in a tertiary referral center between 2016 and 2020. According to the preoperative serum albumin level, they were divided into two groups: <35 g/ L and ≥35 g/ L. To reduce potential confounding, propensity score matching (PSM) in a 1:1 ratio was performed, with the caliper value set as 0.002; and further conditional logistic regression analysis was used to control the other potential confounders to determine the association strength.ResultsAmong 3,147 eligible patients included, PSM yielded 1,318 matched patients, with 659 in each respective group, suggesting significantly improved balance in most variables (standardized mean deviation improvement range, 20.7% to 99.1%), except for basophil count. The conditional logistic regression analysis, adjusted for PS and other intra- or post-operative variables, showed 6.18-fold (relative ratio, 6.18; 95% CI, 3.15–11.98; P<0.001) increased risk of postoperative pneumonia associated with preoperative hypoalbuminemia.ConclusionPreoperative hypoalbuminemia was identified to be independently and highly associated with development of postoperative pneumonia in elderly patients undergoing hip fracture surgeries. However, whether the patients who had such condition may benefit from preoperative targeted nutritional support needs to be clarified by more prospective studies.

Incidence and risk factors for postoperative pneumonia following surgically treated hip fracture in geriatric patients: a retrospective cohort study

ObjectiveLarge sample investigations for risk factors for pneumonia in elderly patients after hip fracture surgeries are lacking. The purpose of this study is to determine the incidence and risk factors for postoperative pneumonia in geriatric patients following hip fracture operations.MethodsA retrospective study of incidence and risk factors in a tertiary referral center between 2016 and 2020 was conducted. Geriatric patients who developed postoperative pneumonia after surgeries of hip fracture during hospitalization stay were defined as cases and those without as controls. Multivariate logistic regression model was used to evaluate risk factors for postoperative pneumonia.ResultsThis study included 3147 patients, and 182 developed postoperative pneumonia, denoting the rate of 5.8%. In the multivariate analyses, age (OR 1.04; 95% CI 1.02–1.06), sex (males) (OR 2.27; 95% CI 1.64–3.13), respiratory disease (OR 3.74; 95% CI 2.32–6.04), heart disease (OR 1.68; 95% CI 1.14–2.47), cerebrovascular disease (OR 1.58; 95% CI 1.11–2.27), liver disease (OR 2.61; 95% CI 1.33–5.15), preoperative stay (OR 1.08; 95% CI 1.05–1.11) and general anesthesia (OR 1.61; 95% CI 1.15–2.27) were identified as independent risk factors for postoperative pneumonia.ConclusionsThis study identified several risk factors for pneumonia in geriatric patients after hip fracture operations, providing a viable preventive strategy for optimizing clinical conditions for reduction of postoperative pneumonia.

Aspiration pneumonia and anesthesia techniques in hip fracture surgery in elderly patients: A retrospective cohort study using administrative data.

Purpose: Aspiration pneumonia is a critical issue. General anesthesia may suppress the airway's protective reflex. However, aspiration pneumonia is also observed in patients who undergo hip fracture surgery under spinal anesthesia. The aim of this study was to investigate the relationship between anesthesia methods and aspiration pneumonia as well as the predictive factors of aspiration pneumonia in elderly patients undergoing hip fracture surgery. Methods: The medical records of 19,809 patients aged ≥60years who underwent hip fracture surgery under general or spinal anesthesia were reviewed. After propensity score matching, the anesthesia methods affecting the occurrences of aspiration pneumonia and other complications were investigated via logistic regression and instrumental variable analyses. Predictive factors of aspiration pneumonia were also investigated in all subjects using a multivariable logistic regression analysis. Results: Among the 11,673 general anesthesia patients and 8136 spinal anesthesia patients, aspiration pneumonia occurred in 356 patients (1.8%). Post-propensity score matching the incidences of aspiration pneumonia with general and spinal anesthesia were 1.8% and 1.5%, respectively (p = 0.158); other pulmonary complications were 1.5% and 1.5%, respectively (p = 0.893); and the mortality rates were 1.4% and 1.2%, respectively (p = 0.219). The predictive factors of aspiration pneumonia were advanced age, male sex, lean body, cerebrovascular disease, dementia, and dependency for activities of daily living (eating). Conclusion: Spinal and general anesthesia showed similar incidences of aspiration pneumonia in elderly hip fracture surgery. Regardless of the anesthesia method, great care should be taken, especially in elderly patients with the identified predictive factors.

Prognostic Impact of Long-term Postoperative Pneumonia in Elderly Patients with Early Gastric Cancer.

Background: Elderly patients with stage I gastric cancer, a disease that is curable by surgery, easily develop long-term postoperative pneumonia (LTPP) within two years after surgery despite showing no active symptoms. The present study assessed whether or not LTPP determines the later prognosis among elderly patients.Methods: We retrospectively examined patients >75 years old who underwent R0 gastrectomy for gastric cancer and were diagnosed with T1 disease at National Cancer Center Hospital between 2005 and 2012. LTPP was evaluated by chest computed tomography every year until two years after surgery.Results: Of the 3412 patients who underwent gastrectomy in our hospital during this period, 159 were included in this study. The elderly patients who developed LTPP had a worse prognosis than those who did not. Furthermore, their comorbidities and LTPP were significant independent risk factors for a poor prognosis. Patients who developed LTPP had a significantly higher risk of dying due to respiratory disease or cardiovascular disease than those without pneumonia.Conclusions: LTPP was significantly related to a poor survival and death from respiratory disease. To improve the prognosis, not only nutritional support but also exercise and rehabilitation program may be required for patients who develop LTPP within two years after surgery.

Outpatient COVID-19 Pneumonia in elderly Patients in Kazakhstan

Outpatient COVID-19 Pneumonia in elderly Patients in Kazakhstan

Factors affecting cough peak flow in elderly pneumonia patients

Factors affecting cough peak flow in elderly pneumonia patients

The relationship between the expression of serum IL-18 mRNA, CC16, and sTREM-1 and the severity and prognosis of ventilator-associated pneumonia in elderly patients.

This study aimed to explore the relationship between the severity and prognosis of elderly patients with ventilator-associated pneumonia (VAP) and the expression of serum interleukin-18 mRNA (IL-18 mRNA), Clara cell secretory protein 16 (CC16) and the soluble triggering receptor expressed on myeloid cells 1 (sTREM-1). The patients were divided into a VAP group (n=75) and a non-VAP group (n=110). According to the Acute Physiology and Chronic Health Evaluation II (APACHEII) score, the patients with VAP were divided into a low-risk group, an intermediate-risk group and a high-risk group. According to the 28-day outcome, the patients were divided into a survival group and a death group. Serum levels of IL-18, CC16 and sTREM-1 were detected, and their value in the prediction and prognosis of VAP was analyzed using a receiver operating characteristic (ROC) curve. Serum levels of IL-18 and sTREM-1 in the VAP group were higher than those in the non-VAP group, while CC16 levels were lower in the VAP group than those in the non-VAP group (P<0.05). Serum levels of IL-18 and sTREM-1 decreased in order from the high-risk group to the intermediate-risk group to the low-risk group, while CC16 levels increased in order (P<0.05). ROC curve analysis showed that the Youden index and AUC of combined diagnosis of VAP with serum IL-18 mRNA, CC16 and sTREM-1 were 0.710 and 0.930, which were higher than those of single diagnosis (P<0.05). Serum levels of IL-18 mRNA and sTREM-1 in the survival group were lower than those in the death group, and the CC16 level was higher than that in the death group (P<0.05). ROC curve analysis showed that the Youden index and AUC of combined diagnosis with serum IL-18 mRNA, CC16 and sTREM-1 were 0.506 and 0.731, which were higher than those of single diagnosis (P<0.05). The combination of these 3 factors is of high value in predicting the severity and prognosis of VAP and can provide reference for clinical treatment.

Impact of Type of Gastrectomy on Death from Pneumonia in Elderly Patients with Gastric Cancer Over the Long Term.

Gastrectomy may induce significant postoperative disabilities and worsen the quality of life in elderly patients. Without a functioning esophagogastric junction (EGJ), swallowing is impaired because of the anatomical and physiological changes after surgery, which increases the risk of postoperative pneumonia. The aim of this study was to identify the impact of the type of surgical procedure on death from pneumonia in elderly patients with gastric cancer (GC) over the long term. We analyzed the data of 343 patients with GC who underwent curative gastrectomy in our hospital. We divided the patients into elderly and non-elderly groups. Among them, 109 patients aged ≥ 75years who underwent curative resection were analyzed, their clinicopathological factors and clinical outcomes were compared, and the impact of the type of surgical procedure on death from pneumonia over the long term was evaluated. The institutional scientific review board of Kumamoto University Hospital was approved for data collection and analysis (No. 1037). There were significantly higher levels of American Society of Anesthesiologists (ASA) and poor nutrition in the elderly group; however, gender, BMI and factors related to pneumonia did not differ significantly between groups. The median duration of follow-up time 1588days. On the multivariate analysis, age and surgical procedure were selected as independent predictive factors for pneumonia-related survival. Preservation of the EGJ as much as possible while maintaining curability is useful for reducing postoperative death from pneumonia over the long term in elderly patients with gastric cancer.

Evaluating a novel swallowing assessment as a predictor of mortality and recurring pneumonia in elderly patients with pneumonia.

Assessment of swallowing functions in elderly people with pneumonia is important. Videofluoroscopic and videoendoscopic examinations have been known as reliable assessments of swallowing functions. However, it is often difficult to use these tools in patients with pneumonia due to their poor condition and/or inadequate hospital facilities. We have previously constructed the Assessment of Swallowing Ability for Pneumonia (ASAP) as a straightforward evaluation for swallowing function. This study investigates the efficacy of the ASAP in predicting several outcomes in elderly patients with pneumonia. Elderly patients with pneumonia (n=130) who were admitted to Tobata Kyoritsu Hospital from January to June 2016 were enrolled prospectively. Associations between their ASAP scores and in-hospital mortality, recurrence of pneumonia within 30 days, 6-month mortality, and detection of antibiotic-resistant bacteria were evaluated. Lower ASAP scores were associated with higher rates of in-hospital mortality, recurrence of pneumonia, and 6-month mortality. The areas under the curve were 0.84 (95% confidence interval [CI], 0.72-0.96) for in-hospital mortality, 0.76 (95% CI, 0.67-0.85) for recurrence of pneumonia, 0.74 (95% CI, 0.64-0.84) for 6-month mortality, and 0.67 (95% CI, 0.52-0.82) for detection of antibiotic-resistant bacteria. Multivariate analysis showed that a lower ASAP score was an independent risk factor for in-hospital mortality, recurrence of pneumonia, and 6-month mortality. The ASAP was useful for predicting short- and long-term mortalities and recurrence of pneumonia.

Diagnostic accuracy of pocket-sized ultrasound for aspiration pneumonia in elderly patients without heart failure: A prospective observational study.

AimTo investigate the diagnostic accuracy of pocket‐sized ultrasound (PsUS) for aspiration pneumonia in elderly patients without heart failure.MethodsThis prospective observational study included patients with aspiration pneumonia. PsUS was performed in six areas (bilateral chest, four dorsal areas) by an independent examiner, blinded to the computed tomography (CT) results as a reference standard. Patients with heart failure were excluded.ResultsPsUS findings of 34 patients (median age, 87.5 years) and 204 areas were analyzed. Three or more B‐lines (comet tail artifacts) were strongly suggestive (positive likelihood ratio [LR+] 17.302) of consolidation on CT (CT‐consolidation, subpleural hypoechoic area with tissue‐like echostructure) or pleural change on CT. Consolidation on US (US‐consolidation) was suggestive of CT‐consolidation or pleural changes on CT (LR+ 6.453). Pleural effusion on US was strongly suggestive (LR+ 10.989) of CT‐consolidation or pleural change on CT. Absence of either three or more B‐lines, US‐consolidation, or US pleural effusion could not rule out CT‐consolidation or pleural change on CT (negative likelihood ratio [LR−] 0.482‐0.683). However, absence of all three findings could rule out abnormal CT findings (LR− 0.230). Chest radiograph findings proved difficult to confirm or exclude CT‐consolidation or pleural changes on CT (LR+ 1.584, LR− 0.489); when combined with PsUS findings, LR− improved to 0.124.ConclusionsThree or more B‐lines or US‐consolidation on PsUS in elderly patients with aspiration pneumonia without heart failure suggested CT‐consolidation or pleural changes on CT. When both PsUS and chest radiograph findings were negative, CT‐consolidation and pleural change could be excluded. Geriatr Gerontol Int 2021; 21: 1118–1124.

Sarcopenia measured with paraspinous muscle using computed tomography for predicting prognosis in elderly pneumonia patients

Background: In the elderly, diagnostic findings of pneumonia are often atypical. Computed tomography was recommended for the diagnosis of pneumonia in elderly patients. Recently, the usage of computed tomography as a screening tool for pneumonia in emergency departments has increased. Sarcopenia is defined as the loss of skeletal muscle mass and strength with aging. In this study, the association between sarcopenia and prognosis measured through computed tomography was evaluated compared to CURB-65. Methods: This study was conducted on patients diagnosed with pneumonia through computed tomography from 1 March 2018 to 31 March 2020. The paraspinous muscle size and attenuation were measured at a level located at the T12 pedicle level on axial computed tomography images. Paraspinous muscle size was presented as paraspinous muscle index. Differences in the prognostic performance among the paraspinous muscle size and attenuation, and CURB-65 were evaluated by the area under the receiver operating characteristic curve. Results: A total of 509 patients were included and 132 patients (25.9%) were admitted to the ICU, and 58 patients (11.4%) died in hospital. Paraspinous muscle index was the significant factor for predicting in-hospital mortality and ICU admission. The area under the receiver operating characteristic value of paraspinous muscle index for prediction of mortality was 0.738 and CURB-65 was 0.707. The area under the receiver operating characteristic of paraspinous muscle index and CURB-65 for predicting ICU admission were 0.766 and 0.704, respectively. Conclusion: As a method of measuring sarcopenia, paraspinous muscle index was superior to CURB-65 in elderly pneumonia patients. The use of computed tomography in predicting prognosis for elderly pneumonia patients will ease the economic burden.