CAP is a leading cause of death. Old age and comorbidities are determinants of outcome; their role in different age groups has not been yet clarified.
Secondary analysis of the CAPO database for hospitalized patients with CAP to identify the impact of age and comorbidities (neoplasm; chronic lung, renal or liver disease; congestive heart failure; diabetes; HIV/AIDS) on patients outcomes. The following age groups were considered: < 65; 65–69; 70–74; 75–79; 80–84; 85–89; 90–94; and > 94 years-old.
Overall, 1903/3273 patients were ≥ 65 years –old. Comorbidities per patient was: 0.79; 1.14; 1.15; 1.22; 1.16; 1.02; 0.93 and 0.79, respectively. Patients ≥ 65 years had more comorbidities (p = 0.001); the number of comorbidites per patient was different for the different age groups. The older the patient was, the less number of comorbidities was present for the 75 –79; 80 –84; 85 –89; 90 –94; and > 94 years-old age groups, comparing every group with each other. Mortality was higher in ≥ 65 years; in those with 0 or 1 comorbidities mortality was between 4 and 5% for the groups < 65; 65–69; 70–74 and 75–79 years–old (p = NS). Centennials ( > 90 years) had higher mortality, however, those > 94 years showed a trend to lower mortality than the 90–94 age group (p = NS).
Age and comorbidities are associated with poorer outcomes in CAP. The incidence of comorbidities was reduced after the age of 80 years old. Two or more comorbidities correlated with poorer outcome in patients younger than 80. Age > 94 years old may indicate the survivorship of healthier population with less comorbidities and a trend to a lower mortality.
Progress in medicine produce continuous ageing of the population. The elderly have higher incidence and mortality due to CAP. The clarification of the meaning of the observed differences may be important to improve their care.
Ileana Palma, No Financial Disclosure Information; No Product/Research Disclosure Information