bstract:Community-acquired pneumonia (CAP) is an increasing problem among the elderly.
Multiple factors related to ageing, such as comorbidities, nutritional status and swallowing
dysfunction have been implicated in the increased incidence of CAP in the older population.
Moreover, mortality in patients with CAP rises dramatically with increasing age.Streptococcus
pneumoniaeis still the most common pathogen among the elderly, although CAP may also be
caused by drug-resistant microorganisms and aspiration pneumonia. Furthermore, in the
elderly CAP has a different clinical presentation, often lacking the typical acute symptoms
observed in younger adults, due to the lower local and systemic inflammatory response.
Several independent prognostic factors for mortality in the elderly have been identified,
including factors related to pneumonia severity, inadequate response to infection, and low
functional status. CAP scores and biomarkers have lower prognostic value in the elderly, and
so there is a need to find new scales or to set new cut-off points for current scores in this
population. Adherence to the current guidelines for CAP has a significant beneficial impact on
clinical outcomes in elderly patients. Particular attention should also be paid to nutritional
status, fluid administration, functional status, and comorbidity stabilizing therapy in this group
of frail patients. This article presents an up-to-date review of the main aspects of CAP in
elderly patients, including epidemiology, causative organisms, clinical features, and prognosis,
and assesses key points for best practices for the management of the disease.
bstract:Community-acquired pneumonia (CAP) is an increasing problem among the elderly.Multiple factors related to ageing, such as comorbidities, nutritional status and swallowingdysfunction have been implicated in the increased incidence of CAP in the older population.Moreover, mortality in patients with CAP rises dramatically with increasing age.Streptococcuspneumoniaeis still the most common pathogen among the elderly, although CAP may also becaused by drug-resistant microorganisms and aspiration pneumonia. Furthermore, in theelderly CAP has a different clinical presentation, often lacking the typical acute symptomsobserved in younger adults, due to the lower local and systemic inflammatory response.Several independent prognostic factors for mortality in the elderly have been identified,including factors related to pneumonia severity, inadequate response to infection, and lowfunctional status. CAP scores and biomarkers have lower prognostic value in the elderly, andso there is a need to find new scales or to set new cut-off points for current scores in thispopulation. Adherence to the current guidelines for CAP has a significant beneficial impact onclinical outcomes in elderly patients. Particular attention should also be paid to nutritionalstatus, fluid administration, functional status, and comorbidity stabilizing therapy in this groupof frail patients. This article presents an up-to-date review of the main aspects of CAP inผู้ป่วยสูงอายุ ระบาดวิทยา สิ่งมีชีวิตสาเหตุการ ลักษณะทางคลินิก และ การคาดคะเนและประเมินประเด็นแนวทางปฏิบัติสำหรับการจัดการของการเกิดโรค
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