Clinical features and risk factors of recurrent community-acquired pneumonia in elderly patients / 中华全科医师杂志

ABSTRACT

Objective To investigate the clinical features and risk factors of recurrent communityacquired pneumonia (CAP) in elderly patients.Methods Clinical data of elderly CAP patients admitted to the first affiliated hospital of Sun Yat-Sen university from January 2012 to December 2014 were analyzed retrospectively,including 48 cases of recurrent CAP and 299 cases of non-recurrent CAP.The clinical features were compared between two groups,and the risk factors of recurrent CAP were assessed with logistic regression analysis.Results No significant differences were observed between the two groups in age,sex,smoking,drinking,average hospital stays and total hospitalization expenses (all P ＞ 0.05).In the recurrent pneumonia group,the chronic obstructive pulmonary diseases [54.2％ (26/48) vs.35.5％ (106/299),χ2 =6.146,P=0.013],diabetes [41.7％ (20/48) vs.19.7％ (59/299),χ2 =11.317,P=0.001],the clinical symptoms include cough [79.2％ (38/48) vs.58.5％ (175/299),χ2 =7.432,P =0.006],sputum [70.8％ (34/48) vs.54.5％ (163/299),χ2 =4.488,P =0.034],fever [64.4％ (31/48) vs.40.8％(122/299),χ2 =9.488,P =0.002],poor appetite [52.1％ (25/48) vs.33.1％ (99/299),χ2 =6.483,P =0.011],choking cough [8.3％ (4/48) vs.2.7％ (8/299),χ2 =3.966,P =0.046],poor spirit [45.8％ (22/48) vs.28.4％ (85/299),χ2 =5.875,P =0.015],bilateral lung lesions [41.7％ (20/48)vs.28.8％ (68/299),χ2 =7.825,P =0.005],the complication of respiratory failure [31.3 ％ (15/48) vs.14.7％ (44/299),χ2 =8.012,P =0.005] were higher than those in non-recurrent group.Logistic regression revealed that chronic obstructive pulmonary disease (OR =2.607,95％ CI1.268-5.358,P =0.009),diabetes (OR =2.948,95％ CI1.457-5.966,P =0.003) and the history of respiratory failure (0R=2.778,95％CI1.264-6.108,P=0.011) were risk factors of recurrent CAP.Conclusions Elderly patients with recurrent CAP has a higher rate of cough,sputum and fever,and the scope of lung lesions is broader.Chronic obstructive pulmonary disease,diabetes and the history of respiratory failure are the independent risk factors for recurrent CAP in the elderly.