Community-acquired pneumonia in the elderly: Spanish multicentre study

Area of Science:

• Geriatrics
• Infectious Diseases
• Epidemiology

Background:

• Community-acquired pneumonia (CAP) incidence is increasing in the elderly population.
• Existing data on the etiology and outcomes of CAP in older adults remain controversial, necessitating further epidemiological research.

Purpose of the Study:

• To prospectively evaluate the clinical features, causative agents, disease progression, and prognostic factors of community-acquired pneumonia in elderly patients admitted to hospitals.

Main Methods:

• A 12-month, multicenter prospective study involving 503 elderly patients (≥65 years) hospitalized with CAP.
• Data collected included clinical presentation, etiological diagnosis, microbial agents, and patient outcomes.
• Multivariate analysis was used to identify factors associated with poor prognosis.

Main Results:

• The most common symptoms were cough (81%) and fever (76%), with symptom onset typically within 5 days (63%).
• Etiological diagnosis was established in 40% of cases, with Streptococcus pneumoniae (49%) and Haemophilus influenzae (14%) being the predominant pathogens.
• The overall mortality rate was 11%. Factors predicting poor prognosis included prior bed confinement, altered mental status, absence of chills, elevated creatinine, low arterial oxygen/inspiratory oxygen ratio, shock, and renal failure.

Conclusions:

• Identifying risk factors for adverse outcomes in elderly CAP patients can guide empiric antibiotic management.
• Prognostic indicators identified in this study can help stratify patients at higher risk for poor evolution, enabling targeted interventions.