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Ann Geriatr Med Res > Volume 19(2); 2015 > Article
Journal of the Korean Geriatrics Society 2015;19(2):80-88.
DOI: https://doi.org/10.4235/jkgs.2015.19.2.80    Published online June 30, 2015.
Pneumonia Observed in a Geriatric Hospital
Chul Hee Kim, Sang Tae Kwak, Ik Chan Song
1Department of Internal Medicine, Seniors Geriatric Hospital, Daejeon, Korea.
2Department of Geriatric Medicine, Seniors Geriatric Hospital, Daejeon, Korea. chulwookk@hanmail.net
3Divsion of Hemato-Oncology, Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea.
요양병원에 입원 중인 환자에서 발생한 폐렴
김철희1?곽상태2?송익찬3
시니어스 요양병원 내과1, 노년의학과2, 충남대학교병원 내과 혈액종양분과3
Abstract
BACKGROUND
In 2026, the elderly population (age> or =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 > or =4 (odds ratio [OR], 9.803; p=0.030), failure to improve clinically in 72 hours (OR, 6.150; p=0.046), respiration rate> or =30/min (OR, 9.370; p=0.021), and serum albumin level< or =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 (> or =30/min), and hypoalbuminemia (< or =3.0 g/dL), escalation of empiric antibiotics or transfer to an acute care setting is necessary to reduce mortality.
Key Words: Geriatrics, Pneumonia, Mortality
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