Pneumonia Observed in a Geriatric Hospital

Abstract

Background: In 2026, the elderly population (age≥65 years) in Korea is projected to be 20.8% of the total population. Along with this rise will be the rise in need for medical care in geriatric hospitals. Geriatric inpatients are vulnerable to infections because of functional disabilities and comorbidities. We investigated the clinical features of pneumonia in the elderly at these facilities. Methods: We performed a retrospective study based on medical records looking at pneumonia, which was identified in 63 inpatients >65 years admitted to a geriatric hospital from October 2013 to December 2014. Results: In-hospital mortality was 31.7% (20/63) and the 30-day mortality was 17.5% (11/63) of the total number of patients. Median age was 83 years (range, 67-94 years). Univariate analysis showed that the following factors were significantly different between survivors and nonsurvivors, number of comorbidities, history of antibiotics therapy in preceding 90 days, clinical improvement in 72 hours, alteration of mentality, respiration rate, serum albumin level, and peripheral blood leukocyte count. Multivariate analysis showed that the independent factors for predicting increased mortality were number of comorbidities ≥4 (odds ratio [OR], 9.803; p=0.030), failure to improve clinically in 72 hours (OR, 6.150; p=0.046), respiration rate≥30/min (OR, 9.370; p=0.021), and serum albumin level≤3.0 g/dL (OR, 32.022; p=0.010). Conclusion: When elderly inpatients with pneumonia have factors such as comorbidities greater than 4, failure to improvement clincally in 72 hours, tachypnea (≥30/min), and hypoalbuminemia (≤3.0 g/dL), escalation of empiric antibiotics or transfer to an acute care setting is necessary to reduce mortality.