Pneumonia in older patients continues to be a serious illness
Pneumonia that starts at home is called “community acquired pneumonia” or “CAP”. This is a serious and potentially life-threatening infection that often requires admission to a hospital.
It is a well-known fact that risk and complications of pneumonia increase with advancing age.
The potential for a favorable impact on the incidence (frequency) and outcome of CAP in the current era with advances in medical care as stated below remains unclear:
- easy accessibility to medical care in most communities
- advances in infection management including new antibiotics, intensive care medicine, among others
- and importantly, infection prevention by more effective, new generation of vaccines
Centers for Disease Control and Prevention evaluated community-acquired pneumonia in 2,320 adults residing in Chicago and Nashville between 2010 and 2012. They reported patients with CAP had a median age of 57 years. A large number of patients with pneumonia had underlying chronic lung disease (42%), chronic heart disease (35%) and/or diabetes (26%).
Among those who required hospitalization for CAP, one fifth of patients (21%) needed urgent treatment in the intensive care unit. Deaths were observed in 2% of patients.
The yearly frequency of pneumonia in these two cities during the study years was 25 cases per 10,000 adults. However, the rate got substantially higher with increasing age; 63 cases per 10,000 adults among individuals age 65 to 79 years, and rose to an alarming 164 cases per 10,000 adults for individuals 80 years of age or older. Need for hospitalization was highest among the oldest patients with community acquired pneumonia.
Please take note,
Strep pneumonia (Streptococcus pneumoniae) or pneumococcus is the most common cause of bacterial pneumonia and like influenza, this is a vaccine preventable illness.
Pneumonia acquired at home remains a serious and a daunting challenge, especially in old patients.
Underutilization of the new effective vaccines require urgent attention.
Jain S, Self WH, Wunderink RG, Fakhran S, Balk R, Bramley AM, et al; CDC EPIC Study Team. Community-Acquired Pneumonia Requiring Hospitalization among U.S. Adults. N Engl J Med. 2015 Jul 30;373(5):415-27.