Frequency and relevance of concomitant diseases in elderly patients hospitalized for community acquired pneumonia

Abstract

Introduction. Patients' age and concomitant diseases are relevant for the development and treatment outcome of pneumonia. Objective. To establish the frequency and relevance of concomitant diseases in patients over 65 years of age hospitalized for community acquired pneumonia. Methods. The research included 550 patients hospitalized at the Institute for Pulmonary Diseases of Vojvodina in Sremska Kamenica due to community acquired pneumonia. Data on concomitant diseases and mortality rate was correlated with the patients' age limit of 65 years, and then statistically analyzed and presented in tables. Results. There were 446 (81.45%) patients under and 102 (18.55%) over the age of 65 years. Dyspnea, impaired consciousness, cyanosis, tachycardia and arterial hypertension were significantly more common in patients over 65 years of age, who also had a higher prognostic score. Mortality was significantly higher (21.6% vs. 6.0%) in the patients aged over 65 years (p<0.001). Concomitant diseases were significantly more common (p<0.001) among the patients over 65 years (94.1%vs.69.2%), and the majority of the elderly patients had two or three comorbidities. The following comorbidities were significantly more common among the patients aged over 65 years: chronic obstructive disease, bronchiectasis, compensated and decompensated cardiomyopathy, cardiac arrhythmia, arterial hypertension and diabetes mellitus. The higher number of concomitant diseases was associated with a significantly elevated hospital mortality (p<0.001). A statistically significant mortality rate difference was found in both age groups regarding the comorbidity of chronic obstructive disease and decompensated cardiomyopathy. Conclusion. The patients aged over 65 years hospitalized due to community acquired pneumonia had a statistically significantly higher prognostic score, mortality rate and concomitant diseases than the patients below 65 yeas of age. Most subjects of the older group of patients had two or three comorbidities. Concomitant diseases resulted in a statistically significant hospital mortality elevation. When comborbitities involved chronic obstructive pulmonary disease and decompensated cardiomyopathy, a statistically significant mortality difference was registered in both age groups.

Keywords

• community acquired pneumonia
• elderly patients
• comorbidities