Romero CÁJ

Language: Spanish
References: 21
Page: 344-351
PDF size: 326.32 Kb.

ABSTRACT

Background: Community-acquired pneumonia (CAP) is very common in the elderly and has high mortality and hospitalization rates.
Objective: To identify the mortality factors associated among hospitalized elderly with community-acquired pneumonia.
Patients and method: Case-control study Cases: 40 dead elder patients with community-acquired pneumonia, controls: 40 alive elderly with CAP, randomly selected. The information (demographical, clinical, radiographic and analytical) was obtained by a formulary from the clinical records. The association power of selected variables with the outcome was measured by odd ratio (OR) and 95% confidence interval. Multivariate analysis was performed by logistic regression in an SPSS program v. 10.0. Results were considered significant when p ‹ 0.05. A mortality predictive model was implemented using variables with significance.
Results: The factors associated with mortality by univariate analysis were polimorbility, polipharmacy, immobility, urinary incontinence, cognitive impairment (dementia / confusion), pulse ≥ 95 x min, arterial hypotension, respiratory rate ≥ 31, elevated serum creatinine and bilateral affectation in chest X ray. The clinical variables with higher association power in multivariate analysis were polimorbility and confusion. The presence of three or more geriatric syndromes (polimorbility, immobility, urinary incontinence, dementia and confusion) had high specificity and a high positive predictive value in association with mortality. From all of these, polimorbility and cognitive impairment had a 93,71 % specificity and a 90,68 % positive predictive value.
Conclusions: Polimorbility and cognitive impairment were associated with CAP mortality in hospitalized elderly.

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