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Age-related differences in management and outcomes in hospitalized healthy and well-functioning bacteremic

Luis A Ruiz1, Pedro P España2, Ainhoa Gómez3

  • 1Pneumology Service, Hospital Universitario Cruces, E-48903, Barakaldo, Bizkaia, Spain. luisalberto.ruiziturriaga@osakidetza.eus.

BMC Geriatrics
|June 22, 2017
PubMed

Insights

Older, healthy patients with bacteremic pneumococcal pneumonia face higher mortality despite fewer ICU admissions and shorter hospital stays. Age significantly impacts outcomes, independent of functional status.

Area of Science:

  • Medicine
  • Infectious Diseases
  • Geriatrics

Background:

  • Limited data exist on age-related differences in pneumonia presentation and outcomes among healthy individuals.
  • Bacteremic pneumococcal community-acquired pneumonia (BP-CAP) affects diverse age groups.

Purpose of the Study:

  • To investigate the association between age and clinical presentation, serotype, and outcomes in healthy patients with BP-CAP.
  • To compare outcomes between younger (18-64 years) and older (≥65 years) healthy patients hospitalized with BP-CAP.

Main Methods:

  • Prospective cohort study of consecutive healthy and well-functioning patients hospitalized with BP-CAP.
  • Stratification into younger and older age groups for comparative analysis.
  • Multivariate analysis to adjust for potential confounding factors.

Main Results:

  • Older patients showed no significant differences in antibiotic treatment, treatment failure, or antibiotic resistance compared to younger patients.
  • Serotype 7F was less common in older patients.
  • Older patients had higher 30-day mortality (OR 6.83), were less likely to be admitted to the ICU (OR 0.14), and had shorter hospital stays (OR 0.71).

Conclusions:

  • Healthy, well-functioning older adults with BP-CAP experience higher mortality than their younger counterparts.
  • Despite increased mortality risk, older patients were less likely to require ICU admission and had shorter hospitalizations.
  • The aging process appears to be a critical determinant of mortality in BP-CAP, irrespective of functional status.
Abstract

Keywords:
Bacteremic pneumococcal pneumoniaCommunity-acquired pneumoniaPneumonia in older people

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