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1 Servicio de Neumología, Hospital de Cruces, Bilbao, 2 Servei de Pneumología i Allèrgia Respiratoria, Institut Clínic de Pneumologia i Cirurgía Torácica, Hospital Clinic, Barcelona, 3 Unidad de Cuidados Intensivos Respiratorios, Hospital Clínico, Valencia, 4 Servicio de Neumología, Hospital La Princesa, Madrid, 5 Sección de Neumología, Hospital Mutua Terrassa, Barcelona, 6 Servicio de Neumología, Hospital La Fé, Valencia, 7 Servicio de Neumología, Hospital Dr Peset, Valencia, and 8 Sección de Neumología, Hospital San Jorge, Huesca, Spain
CORRESPONDENCE: TorresR. Zalacain, Secretaría SEPAR (Area TIR), Balmes 68 Pral, 08007, Barcelona, Spain. Fax: 34 934878509. E-mail: ssepar@separ.es
Keywords: aetiology, clinical characteristics, community-acquired pneumonia, elderly, prognostic factors
Received: July 17, 2002
Accepted October 15, 2002
This study was sponsored by the "Area de Tuberculosis e Infecciones Respiratorias (TIR)", Sociedad Española de Neumología y Cirugía Torácica (SEPAR) and Aventis.
Community-acquired pneumonia (CAP) in the elderly has increased as a consequence of an overall increase of the elderly population. A controversy about the aetiology and outcome of CAP in this population still exists and more epidemiological studies are needed.
A prospective, 12-month, multicentre study was carried out to assess the clinical characteristics, aetiology, evolution and prognostic factors of elderly patients (
The clinical picture lasted
The results of this study may aid in the management of empiric antibiotic treatment in elderly patients with community-acquired pneumonia and the patients who have a greater probability of bad evolution may be identified based on the risk factors.
65 yrs) admitted to hospital for CAP. The study included 503 patients (age 76±7 yrs). 
5 days in 318 (63%) and the main clinical features were cough (n=407, 81%) and fever (n=380, 76%). Aetiological diagnosis was achieved in 199 (40%) cases, with a definite diagnosis obtained in 164 (33%). Of the 223 microorganisms isolated the main agents found were Streptococcus pneumoniae in 98 (49%) and Haemophilus influenzae in 27 (14%). A total of 53 patients died (11%) and the multivariate analysis showed the following factors of bad prognosis: previous bed confinement, alteration in mental status, absence of chills, plasma creatinine 1.4 mg·dL–1, oxygen tension in arterial blood/inspiratory oxygen fraction ratio <200 at the time of admission, and shock and renal failure during the evolution.
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