ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG VÀ MỘT SỐ YẾU TỐ LIÊN QUAN ĐẾN KẾT QUẢ ĐIỀU TRỊ VIÊM PHỔI MẮC PHẢI CỘNG ĐỒNG Ở BỆNH NHÂN LỚN TUỔI

Abstract

Background: Community-acquired pneumonia (CAP) is a common disease in the elderly, with a high mortality rate. Objectives: Describe clinical and subclinical characteristics and identify factors related to mortality in elderly patients with CAP. Materials and methods: Patients aged 60 years and older admitted to the hospital with a diagnosis of CAP according to the guidelines of the Ministry of Health, at the Geriatric Department, Intensive Care and Anti-Poisoning Department from May 2024 to October 2024. Results: The median age of patients was 76 (interquartiles: 66 - 85 years old), male patients (60%). Patients with a history of 2 underlying diseases when admitted to the hospital accounted for the highest proportion (38,5%). The most prevalent underlying diseases were hypertension  (78,5%). Common clinical symptoms included cough and expectoration. Bilateral bronchopulmonary lesions on chest X-ray accounted for the highest rate (46,2%). Blood cultures (24,6%), positive blood cultures were 62,5%. Bacterial strains found in blood cultures were Proteus Mirabillis (30%), followed by Pseudomonas aeruginosae (20%), Klebsiella pneumoniae (20%), Burkho. Cepiacia (20%). The median number of days of treatment was 10 (interquartiles: 7 - 18 days). Most patients (86,2%) survived and were discharged from the hospital, mortality was 13,8%. The risk of death for patients with CAP included SIRS ≥ 2 points (RR = 1,27, 95% CI: 1,08-1,48; P=0,02), lesions on chest X-ray (RR = 1,29, 95% CI: 1,09-1,53; P=0,01), positive blood cultures (RR = 3,21, 95% CI: 1,25-8,29; P<0,01). Conclusion: Community-acquired pneumonia is common in the elderly with multiple underlying diseases. Clinical symptoms include cough and expectoration. Factors associated with mortality include: Patients with SIRS  ≥ 2 points, chest X-ray lesions, and positive blood cultures.