[Incidence and clinical characteristics of community-acquired pneumonia managed as outpatient among elderly people in Tarragona-Valls, Spain].
BACKGROUND
Few information exists about community-acquired pneumonia (CAP) not hospitalized. This study assessed incidence and clinical characteristics of community-acquired pneumonia (CAP) managed as outpatient among elderly population.


METHODS
Prospective cohort study that included 11,240 individuals 65 years or older who were assigned to 8 Primary Care Centers in the region of Tarragona-Valls, Spain. All cases of CAP managed as outpatient occurred among cohort members from January 1, 2002 to April 30, 2005 were included. All cases were x-ray proved and validated by checking clinical records.


RESULTS
An amount of 118 cases of CAP managed as outpatient were observed (45 diagnosed in Primary Care and 73 diagnosed in Emergence Units) which means an incidence of 34.8 cases per 10,000 elderly persons-year (95% CI: 28.8-41.7). Incidence was greater among males (41.9 per 10,000) and among those aged 75 years or older (47.5 per 10,000). When diagnosis, 68.6% of patients had fever, (80% in 65-74 years and 60.3 in 75 years or older, p=0.037), 36.4% dyspnea, 44.9% pleural pain, 77.1% cough, 50.0% expectoraton and 5.7% had altered mental state. The combination of "fever, cough and pleural pain" occurred in 27.1% of cases (95% CI: 19.3-36.1).


CONCLUSIONS
The incidence of outpatient CAP among elderly people is considerable. A great proportion of cases, specially older patients, had not typical clinical manifestations of pneumonia.
Vila Córcoles
Angel
A
Servicio de Atención Primaria de Tarragona-Valls, Dirección de Atención Primaria Camp de Tarragona, Institut Català de la Salut (ICS), Tarragona. avila.tarte.ics.@gencat.cat
Rodríguez Blanco
Teresa
T
Ochoa Gondar
Olga
O
Salsench Serrano
Elisabet
E
de Diego Cabanes
Cinta
C
Valdivieso López
Amparo
A
D000368:Aged; D000369:Aged, 80 and over; D017714:Community-Acquired Infections / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D010045:Outpatients; D018410:Pneumonia, Bacterial / Q000175:diagnosis* / Q000453:epidemiology*; D011446:Prospective Studies; D013030:Spain