Clinical spectrum of community acquired pneumonia (cap) in geriatric population-a prospective cross-sectional study

Background: Community-acquired pneumonia in adults has a morbidity and mortality ranging between 10% and 29%. Increasing age is associated with a higher mortality. The factors influencing the outcome in elderly patients are thought to be different from those in young adults. We, therefore, studied the clinical profile and predictors of outcome in adults with community-acquired pneumonias. Methods: 540 patients with community-acquired pneumonia were included in the study over a period of 12 months. A detailed history was obtained and physical examination done. A chest X-ray was done to establish the diagnosis and haematological, biochemical and arterial blood gas estimations were carried out. CECT Chest was done in selected cases. The data of survivors and non-survivors between 65 to 85 yrs were analysed to determine the clinical profile and outcome in these groups. Results: The clinical features, laboratory parameters and complications from pneumonia were analysed. Males were more commonly affected than females (1.5:1).8.5% of elderly patients succumbed tofulminant sepsis followed by pleural effusion (5.9%). Old age, history of smoking, presence of chronic obstructive airways disease, late presentation to hospital, systolic and diastolic hypotension, high blood urea, raised liver enzymes and development of septic shock were associated with a higher incidence of complications and a poorer prognosis. Inaddition, older patients with a poor outcome also had symptoms for a longer duration and a poor neutrophilic response to infection. Conclusion: The presence of certain factors leads to a higher incidence of complications and a poorer prognosis. These factors are good predictors of outcome. Identification and determining the clinical patterns of community acquired pneumonia helps in adoption of regionally optimized diagnostic approach.