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Pneumonia in the Elderly: Gender Disparity in Presentation FREE TO VIEW

Adekunle S. Ogunfuwa, Medical Resident; Raji Ayinla, MD, FCCP; Gregory Emili, MD
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Mount Sinai School of Medicine, North General Hospital Program, New York, NY


Chest. 2003;124(4_MeetingAbstracts):187S. doi:10.1378/chest.124.4_MeetingAbstracts.187S-b
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PURPOSE:  Evaluate gender disparity in presentations among elderly patients with pneumonia

METHODS:  Review of 107 patients above 65 years hospitalized for community acquired pneumonia. Medical records were abstracted for socio-demographic characteristics, clinical presentations, triage decision, laboratory data and outcome variables.

RESULTS:  The mean age for females in the study is 83.23 years versus 76.86 for males. Pneumonia is commoner among males between 65 – 84 years in the community (44 vs 35%). However, females above 85 years in the same community (18 vs 4%) and those from the nursing homes above 65 years (70 vs 30%) have higher percentage of pneumonia. Males have more co morbid conditions such as COPD, CHF, neoplasm, renal disease and usually present with fever, cough and pleuritic chest pain whereas, females usually present with dyspnea, confusion and higher pneumonia severity index. Females usually require intensive care unit monitoring (26 vs 15%), have longer length of stay (13.02 vs 12.02 days) and higher mortality (23 vs 5%). Enteric gram-negative organisms, staph. species and polymicrobial growth were the major organisms responsible for community acquired pneumonia for both genders either from the community or nursing homes.CONCLUSIONS AND CLINICAL IMPLICATIONS: This study demonstrates that pneumonia is commoner in males between 65-84 years in the community. However pneumonia is seen more among females above 85 years in the same community and those above 65 years who were admitted from the nursing homes. Atypical presentation and unusual pathogenic isolates may have contributed to higher mortality. Hence there is need for higher index of suspicion and initial antibiotic coverage for both gram positive and gram negative organisms.

DISCLOSURE:  A.S. Ogunfuwa, None.

Wednesday, October 29, 2003

12:30 PM - 2:00 PM




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