Clinical characteristics of hospital-acquired pneumonia in bedridden patients aged 90 years and over / 中华老年医学杂志

ABSTRACT

Objective To analyze the clinical characteristics of hospital-acquired pneumonia in bedridden patients aged 90 years and over.Methods From January 1,2015 to August 1,2015,40 bedridden elderly patients(≥90 years)with hospital-acquired pneumonia admitted to Beijing Hospital were assigned into the observation group,with 40 non-bedridden elderly patients (≥ 90 years)with community acquired pneumonia serving as the control group.Basic clinical data,infection symptoms and inflammation markers,and changes in serological test results before and after pneumonia were compared between the groups.Results Compared with the control group,the observation group had much lower body mass index(20.7± 1.2)kg/m2 vs.(25.1 ± 3.1) kg/m2 (t=-8.43,P＜0.01),and was accompanied with more diseases and associated with more symptoms during infection (all P＜ 0.05).Meanwhile,patients with lung infections in the observation group were more likely to have atrial fibrillation,often with increased levels of brain natriuretic peptide(1 047.9 ± 193.5) pg/L vs.(3 387.8± 763.8) μg/L (t =-3.39,P＜0.01) and abnormalities in troponin,but without obvious elevations of inflammatory markers such as white blood cells,C reactive protein and procaleitonin.Conclusions Bedridden patients aged 90 years and over with hospital-acquired pneumonia may show atypical clinical presentations and increased accompanying symptoms.Comprehensive geriatric assessment is critical for good prognosis.