Epidemiologia de la neumonía adquirida en la comunidad en el anciano
Background: Community-acquired pneumonia (CAP) is generally considered a major cause of morbidity and mortality in the elderly. However, population-based data are very limited and its overall burden is unclear. Objective: This study assessed epidemiology, aetiology, clinical outcomes and risk factor...
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| Tipo de recurso: | tesis doctoral |
| Estado: | Versión publicada |
| Fecha de publicación: | 2009 |
| País: | España |
| Institución: | Universitat Rovira i virgili (URV) |
| Repositorio: | Repositori Institucional de la Universitat Rovira i Virgili |
| OAI Identifier: | oai:urv.cat:TDX:524 |
| Acceso en línea: | https://hdl.handle.net/20.500.11797/TDX524 http://hdl.handle.net/10803/8745 |
| Access Level: | acceso abierto |
| Palabra clave: | 616.9 - Malalties infeccioses i contagioses. Febres |
| Sumario: | Background: Community-acquired pneumonia (CAP) is generally considered a major cause of morbidity and mortality in the elderly. However, population-based data are very limited and its overall burden is unclear. Objective: This study assessed epidemiology, aetiology, clinical outcomes and risk factors for community-acquired pneumonia (CAP) among Spanish community-dwelling 65 years or older from Tarragona.Methods: Prospective cohort study that included 11,240 individuals aged 65 years or older, who were followed from January 2002 until April 2005. Primary endpoints were all-cause CAP (hospitalised and outpatient) and 30-day mortality after the diagnosis. All cases were radiographically proved and validated by checking clinical records. Results: Incidence rate of overall CAP was 14 cases per 1,000 person-year (10.5 for hospitalised CAP and 3.5 for outpatient CAP). Incidence was almost three-fold higher among immunocompromised patients (30.9 per 1000) than among immunocompetent subjects (11.6 per 1000). Maximum incidences were observed among patients with chronic lung disease and long-term corticosteroid therapy (46.5 and 40.1 cases per 1000 person-year, respectively). Overall 30-days case-fatality rate was 12.7% (2% in cases managed as outpatient and 15% in hospitalised patients). Among 358 patients with an aetiological workup, a total of 142 pathogens were found (single pathogen in 121 cases and mixed pathogens in 10 cases). Streptococcus pneumoniae was the most common pathogen (49%), followed by Pseudomona aeruginosa (15%), Chlamydia pneumoniae (9%) and Haemophillus influenzae (6%). The most common symptoms were respiratory symptoms and fever. The mortality was directly correlated with the Fine score.In multivariable analysis, the variables most strongly associated wit |
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