ACTA FAC MED NAISS 2011;28(2):71-76

Review article

UDC:616.24-002-07-053.9

 

Prognostic Mortality Factors of Community - Aquired Pneumonia in the Elderly

 

Tatjana Pejčić1,2, Ivanka Đorđević2, Ivana Stanković1,2, Desa Nastasijević Borovac2, Tatjana Rađenović Petković2

1University of Niš, Faculty of Medicine, Serbia

2Clinic for Lung Diseases and TB Knez Selo, Clinical Center Niš, Serbia


SUMMARY

The geriatric population i.e. the elderly population is comprised of people older than 65, or, according to some authors, older than 75, which is relative, given the fact that there is often a mismatch between an individual’s biological age and chronological age. Aging is a rather complex process during which various changes occur - both the physiological functions and composition of the human body under-go changes. Many are irreversible, inevitable and additive. Physiological changes that lead to the decrease in the function of the airways and the lungs occur as a person ages. Clinical characteristics of pneumonia in the elderly population have special markers. Several centuries ago, Osler described pneumonia in the elderly population as able to manifest itself without the shivers and elevated temperature, with a slight cough and expectoration. This description, although provided centuries ago, is still held valid. About 45% of elderly people exhibit high temperature with pneumonia. An altered mental status such as confusion is found in 70% of the elderly patients with pneumonia. Given the fact that the mortality rate from the community-acquired pneumonia in elderly patients is significantly higher than the rate in younger population, certain prognostic mortality markers have been examined. Some of the most important prognostic mortality factors include: old age, associated diseases, high breathing frequency, the multilobular character of the pneumonic shadow, high levels of certain biochemical analyses, hypoxemia, hyponatremia, and the untimely application of the empirical antibiotic treatment.

 

Key words: community acquired pneumonia, elderly patients, prognostic mortality factor