Abstract

ZUBILLAGA GARMENDIA, G. et al. Pneumonia above 80 years, admitted to the hospital. An. Med. Interna (Madrid) [online]. 2008, vol.25, n.3, pp.117-121. ISSN 0212-7199.

Objetive: To analize and compare differences in patients older than 80 years with Community acquired Pneumonia admitted in Internal Medicine or Pneumology of a General Hospital from the Emergency Room. Material and methods: Retrospective study of all the 277 patients above 80 years admitted into the Hospital in 2005 with the main diagnosis of Pneumonia. Results: 84% community-acquired, 16% from Institutions. Mean age: 85.8 y (48% men, 52% women). 19% FINE-3, 49% FINE-4, 32% FINE-5. Known etiology: 25% (Pneumococcal 19%, H. Influenzae and other Gram (-) 6%. 75% treated by Internists, 22% treated by Pneumologists. Standard Guidelines followed up by 30,5% a variant 60% (Equal by Internists or Pneumologists). Time door-1st antibiotic dose 6.6 hours. Global Mortality 16.7%. Women died at 87.4 y, men at 84.5 y (p = 0.035). Mortality FINE 3-4-5: 4.5, 12.4, 30% respectively. Mortality treated before 4 hours: 34.6%, after 4 hours: 11.5% (p = 0.01). Many more FINE 5 cases in Int. Medicine than Pneumology. Mortality by Internists 22%. Mortality by Pneumologists 3% (p = 0.001). Mortality similar following strict guidelines or variant. Conclusions: a) Internist receive patients sicker than Pneumologists; b) Important mortality in these very old patients of 16.7%, and progressive according the FINE severiy index, in spite of correct therapy; c) Rapid initiation of Antibiotics did not decreased mortality; d) Mortality did not change following strict or variant Guidelines; and e) There are areas of quality improvement in our Hospitals.

Keywords : Pneumonia; Elderly; Aged, 80 and over; Treatment; Therapy; Hospitalist.

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