Risk Factors, Pathogen Distribution, and Treatment Strategies for Mortality in Elderly Patients with Pulmonary
Zehua Chen1,2, Nan Bai1, Yulong Chi1,2
1Center of Medicine Clinical Research, Department of Pharmacy, Medical Supplies Center, Chinese PLA General Hospital, Beijing, People's Republic of China.
Background:
Elderly patients are particularly vulnerable to pulmonary infections due to immune system decline and comorbidities. This study aims to evaluate the distribution of bacterial pathogens, patterns of antimicrobial resistance, medication strategies, and risk factors associated with mortality in elderly patients with pulmonary infections.
Methods:
Data were collected from electronic medical records, encompassing demographic information, clinical characteristics, laboratory results, treatment strategies, and outcomes. Risk factors associated with mortality were identified using the Least Absolute Shrinkage and Selection Operator regression model and were subsequently validated through multivariable logistic regression. Differences between groups were assessed using the independent t-test or Mann-Whitney U-test for continuous variables, and the chi-square test or Fisher's exact test for categorical variables.
Results:
201 patients were included with 70.6% being male. Clinical improvement was observed in 124 patients, while 77 patients died. Gram-negative bacteria were identified as the most common pathogens, with Acinetobacter baumannii (27.5%), Klebsiella pneumoniae (23.5%), and Pseudomonas aeruginosa (13.2%) being the most frequently isolated species. Notably, 66.0% of the bacterial strains were classified as multidrug-resistant. Furthermore, 65.7% of the patients received combination therapy. Seven risk factors associated with mortality were identified. Body mass index emerged as a protective factor, whereas length of duration, gastrointestinal bleeding, respiratory failure, bacteremia, myocardial infarction, and mechanical ventilation significantly increased the risk of death.
Conclusion:
Respiratory failure, mechanical ventilation, gastrointestinal bleeding, extended hospitalization, bacteremia, myocardial infarction, and malnutrition were key risk factors related to mortality in elderly patients with pulmonary infections. Early identification and intervention targeting these risk factors are crucial for improving clinical outcomes.
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