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Official Journal of the Italian Society of Thoracic Endoscopy
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Minerva Pneumologica 2004 September;43(3):99-106

language: Italian

Community-acquired pneumonia in the elderly: etiology, clinical aspects and prognostic factors

Putinati S., Ballerin L., Piattella M., Ritrovato L., Zabini F., Potena A.


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Aim. Community-acquired pneumonia (CAP) has increased as a consequence of an overall increase of the elderly population. A controversy about the etiology and outcome of CAP in this population still exists and more epidemiological studies are needed. A prospective, 3-years study was carried out to assess the clinical characteristics, etiology, evolution and prognostic factors of elderly patients („65 years) admitted to hospital for CAP.
Methods. The study included 311 patients (176 male, 135 female, age 79±7.9) who were assigned to risk classes according to Fine et al. The typical clinical picture (fever, cough, purulent expectoration and pleural pain) was seen in 214 cases (68.8%).
Results. Etiological diagnosis was achieved in 65 (20.9%) cases. Of the 89 microorganisms isolated, the main agents found were Pseudomonas aeruginosa in 23 (26.1%) and Streptococcus pneumoniae in 19 (21.5%) cases. There were 42 (13.5%) deaths and the prognostic factors in multivariate analysis were: creatinine level „1.4 mg/dl, and mechanical ventilation.
Conclusion. The prediction rule of Fine et al. proved to give valid estimations regarding clinical outcome variables of community-acquired pneumonia in the elderly.

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