Abstract
AIM: To evaluate differences in clinical presentation and outcome in elderly patients admitted to our hospital with CAP due to Legionella pneumophila.
METHODS: We have included patients with CAP due to L. pneumophila admitted to our hospital between 01-01-2002 and 31-12-2013. Patients were divided in two groups: 1- Age<65 years. 2- Age≥ 65 years (elderly patients). The following data were collected: epidemiological and comorbid conditions, clinical and examination findings, blood tests and chest radiological, and outcome. Microbiological diagnoses were made according to a positive test results for the L. pneumophila urinary antigen.
RESULTS: We evaluated 208 patients (60 elderly). Compared to younger, elderly patients were more likely to be female (p=0,048), current smokers (p=0,0001) and heavy drinkers (p=0,0001). Comorbid conditions diabetes mellitus (p=0,025), congestive heart disease (p=0,002), COPD (p=0,028) and clinical symptoms like altered mental status (p=0,001) were more common in elderly. Laboratory abnormalities such as hyponatremia (p=0,0001) were more frequent in younger but leukocytes(p=0,015) and BUN levels (p=0,0001) were higher in elderly, who also had higher PSI (p=0,0001), CURB65 (p=0,0001) but no differences in ICU admission and mechanical ventilation. There were no differences in hospital stay (9,8 vs 10,6 days) and mortality rates (11,6% vs 5,4%, p= 0,08) between elderly and young.
CONCLUSIONS: 1- Comorbidities and altered mental status were more common in elderly patients. 2-There were no differences in ICU admissions rate although elderly patients were in more severe clinical condition according to PSI and CURB. 3- Higher mortality in elderly patients but no significant differences.
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