흡인성 폐렴 노인과 지역사회획득 폐렴 노인의 임상양상 비교

Abstract

Purpose: This study was done to identify differences between aspiration pneumonia and community acquired pneumonia (CAP) according to demographic characteristics and medical outcomes for elderly patients. Method: From January 2004 to December 2007, data were collected from 105 patients (> 65 years old) with aspiration pneumonia and 311 with CAP. General characteristics, pneumonia severity of illness score (PSI score) and medical outcomes were obtained by reviewing the medical records of those patients. Data were analysed using SPSS window 12.0 version statistics package. Results: The aspiration pneumonia group was older (p<0.05), and more dependent in walking. The incidence of stroke, dementia, Parkinson's disease (p<0.001) and diabetes mellitus (p= 0.027) was higher in the aspiration pneumonia group than in the CAP group. PSI score (121.47 vs 90.65 points), length of hospital stay (17.77 vs 9.94 days) and mortality (17.1 vs 5.1%) were significantly higher in aspiration pneumonia group than in the CAP group. In logistic regression, the factors predicting aspiration pneumonia were Dementia (OR=44.37), Parkinson's disease (OR=18.63), stroke (OR=17.17), confusion (OR=8.62), hypoalbuminemia (OR=2.89). Conclusion: Aspiration pneumonia was more common in dependent malnourished elderly patients with neuro-degenerative diseases. Special attention has to be paid to these patients to decrease the incidence of aspiration pneumonia in the older population.