[Pneumonia above 80 years, admitted to the hospital].
OBJECTIVE
To analyze and compare differences in patients older than 80 years with Community acquired Pneumonia admitted in Internal Medicine or Pneumology of a General Hospital from the Emergency Room.


METHODS
Retrospective study of all the 277 patients above 80 years admitted into the Hospital in 2005 with the main diagnosis of Pneumonia.


RESULTS
84% community-acquired, 16% from Institutions. Mean age: 85.8 y (48% men, 52% women). 19% FINE-3, 49% FINE-4, 32% FINE-5. Known etiology: 25% (Pneumococcal 19%, H. Influenzae and other Gram (-) 6%. 75% treated by Internists, 22% treated by Pneumologists. Standard Guidelines followed up by 30,5% a variant 60% (Equal by Internists or Pneumologists). Time door-1st antibiotic dose 6.6 hours. Global Mortality 16.7%. Women died at 87.4 y, men at 84.5 y (p = 0.035). Mortality FINE 3-4-5: 4.5, 12.4, 30% respectively. Mortality treated before 4 hours: 34.6%, after 4 hours: 11.5% (p = 0.01). Many more FINE 5 cases in Int. Medicine than Pneumology. Mortality by Internists 22%. Mortality by Pneumologists 3% (p = 0.001). Mortality similar following strict guidelines or variant.


CONCLUSIONS
a) Internist receive patients sicker than Pneumologists; b) Important mortality in these very old patients of 16.7%, and progressive according the FINE severity index, in spite of correct therapy; c) Rapid initiation of Antibiotics did not decreased mortality; d) Mortality did not change following strict or variant Guidelines; and e) There are areas of quality improvement in our Hospitals.
Servicios de Medicina Interna, Hospital Donostia, Servicio Vasco de Salud, Departamento de Medicina, Universidad del País Vasco (UPV-EHU), Spain. g.zubillaga@terra.es
G
G
Zubillaga Garmendia
E
E
Sánchez Haya
J
J
Benavente Claveras
E
E
Ceciaga Elexpuru
I
I
Zamarreño Gómez
E
E
Zubillaga Azpíroz
C
C
Sarasqueta Eizaguirre
D000369:Aged, 80 and over; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D018410:Pneumonia, Bacterial / Q000453:epidemiology; D012189:Retrospective Studies