Community-acquired Legionella pneumonia in elderly patients: clinical characteristics and outcome
10.3760/cma.j.issn.0254-9026.2010.08.002
- VernacularTitle:老年人社区获得性军团菌肺炎的临床分析
- Author:
Zhigang ZHANG
;
Xinmin LIU
- Publication Type:Journal Article
- Keywords:
Community-acquired infections;
Pneumonia,bacterial;
Legionella
- From:
Chinese Journal of Geriatrics
2010;29(8):621-624
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze and compare the clinical features of community-acquired pneumonia caused by Legionella in elderly (age≥60 years) and younger patients. Methods The epidemiological, clinical, laboratory data and the outcomes of 80 cases with community-acquired Legionella pneumonia (CALP) from January 2001 to October 2009 were studied retrospectively, and the differences between elderly and younger group were compared using univariate and multivariate analysis. Results (1) Underlying diseases, such as cerebrovascular diseases, chronic obstructive pulmonary diseases, diabetes mellitus and immunosuppressive therapy were significantly more frequent in elderly group than in younger group (all P＜0. 05). (2) No significant differences were observed between the two groups in legionella serotype. (3) Malaise, hyponatremia and hypophosphatemia were all more frequent in elderly group than in younger group (x2=5. 300, 5. 520, 4. 470; P=0. 021,0. 019, 0. 034, respectively). And elderly versus younger group had higher creatinine levels [(108.55±56.57) μmmol/L vs. (75.42±17.62) μmmol/L, t= -3. 062, P=0. 002], lower PaO2/FiO2 (＜300) (57.7% vs. 29.2%, x2=4. 120, P=0.042), less leucocyte counts [(8.34±3.65)×109/Lvs. (10.63±5.02)×109/L, t=-2.287, P=0.022]. (4) Elderly patients more likely complicated with congestive heart failure (P=0.037) and their length of staying in hospital was also longer (Z=-2.194, P=0.028). No significant differences were observed between the two groups in mortality, intensive care unit admission, and the need for corticosteroids or mechanical ventilation.Conclusions Elderly patients with CALP have a higher frequency of underlying comorbidities and more organs involvement than younger patients, although greater severity of illness at onset and outcome are not significantly different between the two groups.
