[Community-acquired pneumonia in the elderly: clinical and nutritional aspects]

Community acquired pneumonia (CAP) in the elderly has unique features and there is little information about the effects of nutrition status on its outcome.

To assess the clinical manifestations and prognostic factors of CAP in immunocompetent elderly patients requiring hospitalization.

Prospective study of all patients with CAP, admitted to Puerto Montt Hospital, Chile over one year. Epidemiológica! and clinical information and laboratory results were recorded. A nutritional assessment was also performed. Outcomes of elderly (>65 years) and young patients were compared.

Two hundred patients aged 63+/- 19 years were studied. Of these, 109 were older than 65 years (78.4+/-8 years) and 91 were younger than 65 years (45.5+/-11 years). Multiple associated diseases, altered mental status, absence of fever, malnutrition and mortality were more common in the older group. Suspected aspiration pneumonia was more common in younger patients, probably related to alcoholism. Malnutrition was associated with longer hospital stay and mortality at any age. An univariate analysis showed that a low serum albumin (<3.4 g/dl) and a mid arm muscle circumference below the 25th percentile were associated with higher mortality.

CAP in the elderly has specific features and malnutrition is associated with a worse prognosis in young and elderly patients.