PNEUMONIA IN NURSING HOME RESIDENTS

  • Renato Eržen Klinika za pljučne bolezni in alergijo Bolnišnica Golnik 4204 Golnik
  • Viktorija Tomič Klinika za pljučne bolezni in alergijo Bolnišnica Golnik 4204 Golnik
  • Mitja Košnik Klinika za pljučne bolezni in alergijo Bolnišnica Golnik 4204 Golnik
  • Ema Mušič Klinika za pljučne bolezni in alergijo Bolnišnica Golnik 4204 Golnik
Keywords: pneumonia, resident home, elderly

Abstract

Background. Pneumonia remains one of the leading causes of morbidity and mortality worldwide, especially in advanced age. Prognosis of the disease depends on premorbid condition and immune competence of the patient, severity of the disease and causative microorganism. In our analysis we wanted to establish clinical, x-ray and microbiological characteristics of pneumonia in nursing home residents, estimate suitability of therapeutic measures and find out risk factors for adverse outcome in this group of patients.

Material and methods. This retrospective study includes all nursing home residents hospitalised due to CAP in Hospital Golnik in 2000. Clinical data was/were evaluated according to case history. Microbiological data and laboratory results were gathered from the patients files. Chi-square test was used for statistical analysis.

Results. 30 patients, 17 women were included, aged 82.5 ± 11.7 years. 60% of patients had at least 2 accompanying diseases, most frequently cardiovascular and neurologic diseases. At admittance 83% of patients presented with severe form of the disease. Dispnea (93%), tachypnea, cough (67%) and confusion (47%) dominate clinical picture. Patients rarely expectorate, are frequently hypoxemic (93%), have leucocytosis (63%), electrolyte disturbances and elevated urea (67%). According to the microbiologic results most frequent causative agents are Enterobacteriae, S. pneumoniae, H. influenzae and also some multiresistant bacteria. Amoxycillin with clavulanic acid was the most frequently used antibiotic, followed by macrolides and 3rd generation cephalosporines.

9 patients died, mortality rate was 30%. Their average age was 83,4 years, 67% of them had more than 2 accompanying diseases, all of them severe form of the disease, 89% severe respiratory insufficiency and 22% positive hemoculture.

Conclusions. Patients are characterised with numerous comorbidities and advanced age. Clinical presentation is unspecific. Mortality is high. Effective therapy is composed from adequate support measures and proper choice of antibiotic – amoxycillin with clavulanic acid, cephalosporines of high generation or antipneumococcal quinolone.

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How to Cite
1.
Eržen R, Tomič V, Košnik M, Mušič E. PNEUMONIA IN NURSING HOME RESIDENTS. ZdravVestn [Internet]. 1 [cited 17Sep.2019];71(10). Available from: https://vestnik.szd.si/index.php/ZdravVest/article/view/1640
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Professional Article