Presentation, etiology and outcome of pneumonia in younger nursing home residents.
J Infect. 2012 Feb 10;
Authors: Klapdor B, Ewig S, Schaberg T, Rohde G, Pletz MW, Schütte H, Welte T
Abstract
OBJECTIVE: Nursing-home acquired pneumonia comprises a pneumonia entity of elderly and comorbid patients with an increased risk for multidrug-resistant (MDR) pathogens and a high mortality. We studied the specific impact of age on the presentation, etiology and outcome of patients with NHAP. METHODS: Data from the prospective multicenter CAPNETZ database were used for a comparison of the hospitalized younger nursing home residents with pneumonia to those aged ? 65 years as regards clinical presentation, comorbidity, severity at presentation, etiology, and outcome. RESULTS: Around 16% of patients with NHAP (n=100) were aged < 65 years and compared to those aged ? 65 years (n=518). Comorbidity was present in most patients with NHAP but the pattern of comorbidity differed significantly. The rate of potential MDR pathogens was low among both age groups (together around 5%). According to the CRB-65 score, NHAP presented less severe in the younger. Short and long-term mortality was twice as low in the younger with rates of 12.9% vs 26.6%, and 24.3% vs 43.8%, p 0.014 and 0.002), respectively. Whereas the rate of mechanical ventilation was more than twofold higher (12% vs 5%) (p=0.008), antimicrobial treatment attitudes did not account for different outcomes. CONCLUSIONS: A considerable proportion of younger patients with pneumonia resides in nursing homes. These differ in terms of clinical presentation, frequency and type of comorbidity, as well as outcome. NHAP is a heterogeneous entity, with age and comorbidity as the main determinant of NHAP characteristics. Keywordspneumonia - nursing home - residency - age - outcome.
PMID: 22330772 [PubMed - as supplied by publisher]