scholarly journals Defining prognostic factors in the elderly with community acquired pneumonia: a case controlled study of patients aged ≥75 yrs

2001 ◽  
Vol 17 (2) ◽  
pp. 200-205 ◽  
Author(s):  
W-S. Lim ◽  
J.T. Macfarlane
Keyword(s):  
Prognostic Factors ◽  
The Elderly ◽  
Community Acquired Pneumonia ◽  
Controlled Study

Community-acquired pneumonia in the elderly: A multivariate analysis of risk and prognostic factors.

1996 ◽  
Vol 154 (5) ◽  
pp. 1450-1455 ◽  
Author(s):  
R Riquelme ◽  
A Torres ◽  
M El-Ebiary ◽  
J P de la Bellacasa ◽  
R Estruch ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
The Elderly ◽  
Community Acquired Pneumonia

scholarly journals 10. Kinetics of Post-Vaccination Seroprotection to S. Pneumonia for the Immune-Compromised and Vaccine-Naïve Populations

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S27-S28
Author(s):  
Jeffrey Gruenglas ◽  
James Mond ◽  
Micaela Scobie ◽  
Cynthia Tolman ◽  
Joseph Martinez
Keyword(s):  
Capsular Polysaccharide ◽  
The Elderly ◽  
Community Acquired Pneumonia ◽  
Prior History ◽  
Antibody Activity ◽  
Vaccine Response ◽  
Serum Samples ◽  
Opsonic Activity ◽  
And Control

Abstract Background S. pneumonia infection presents a significant challenge, accounting for 20–38% of hospital-acquired pneumonia, and the leading cause of community-acquired pneumonia despite availability of effective vaccines. Incidence is highest in children under 2 years, the immunocompromised, and elderly. CDC has reported the emergence of antibiotic resistance in ~30% of cases, adding to risk of morbidity and mortality. Fewer than half of the elderly are vaccinated and vulnerable to infection on admission. Passive immunotherapy as an adjunct to vaccines may improve outcomes in such populations. The objective of this study was to evaluate whether seroprotective response induced with a pneumococcal conjugate vaccine could rapidly yield protective opsonic levels of antibody within anticipated duration of hospitalization. Methods Healthy donors (n=30) were immunized with Prevnar. Blood was drawn on days 0, 3, 7, 10, 14, 21, and 28. Samples were pooled and tested for presence of functional opsonic antibodies recognizing capsular polysaccharides. Clearance mechanism of S. pneumonia was based on antibody recognition to pneumococcal capsular polysaccharide and opsonic titers used as an in vitro surrogate to evaluate the efficacy of vaccine. Results There was little to no opsonic activity against most serotypes on day 0, except for low antibody activity with serotypes 1, 3, 4, and 5. Titers increased, with protective levels achieved by day 10 for most serotypes (except 14 and 18C), peaking at day 14 or after across serotypes (Figures 1 and 2). Average titers rose from log2 titer 2 on day 0 to log2 titer 8 on days 21 and 28. Titers against most serotypes reached log2 10 (titer 1024) or higher. Patients remained susceptible to nosocomial infection for at least 10 days post admission until protective titers are reached. OPK titers (log2 scale) for serum samples on day 0 (pre), day 3, 7, 10, 14, 21, 28, and control for S. pneumoniae serotypes 1, 3, 4, 5, 6A, 6B, 7F, 9V. N=2. OPK titers (log2 scale) for serum samples on day 0 (pre), day 3, 7, 10, 14, 21, 28, and control for S. pneumoniae serotypes 14, 18C, 19A, 19F, and 23F. N=2. Conclusion Patients with no prior history of vaccination (or inability to mount response) with Prevnar or pneumovax remain vulnerable to S. pneumonia infection even if vaccinated on entry, due to delayed kinetics in reaching protective titers. These patients may require prophylactic intervention of hyperimmune Ig with high opsonic titers to S. pneumonia, providing protection until vaccine response elicits protective antibodies. Disclosures All Authors: No reported disclosures

scholarly journals Prognostic factors for the feasibility of chemotherapy and the Geriatric Prognostic Index (GPI) as risk profile for mortality before chemotherapy in the elderly

2015 ◽  
Vol 55 (1) ◽  
pp. 15-23 ◽  
Author(s):  
Ab A. Aaldriks ◽  
Ed Maartense ◽  
Hans J. W. R. Nortier ◽  
Lydia G. M. van der Geest ◽  
Saskia le Cessie ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Prognostic Index ◽  
The Elderly ◽  
Risk Profile

scholarly journals Correlation between two physical activity programs in the gait of sedentary elderly subjects

2010 ◽  
Vol 8 (3) ◽  
pp. 281-284
Author(s):  
Mariana Varkala Lanuez ◽  
Fernanda Varkala Lanuez ◽  
Eduardo Gunther Montero ◽  
Wilson Jacob Filho
Keyword(s):  
The Elderly ◽  
Controlled Study ◽  
Elderly Subjects ◽  
Male And Female ◽  
The Past ◽  
Physical Exercises ◽  
Balance Exercises ◽  
Group A ◽  
Group B ◽  
De Medicina

ABSTRACT Objectives: To assess the effect of exercise on gait using two different programs: a group of aerobic exercises (Group A, n = 18) and a group of flexibility and balance exercises (Group B, n = 19). Methods: A casualized controlled study, in which each sample controlled itself, was undertaken. The sample comprised 37 male and female subjects, aged from 60 to 90 years, from the outpatient clinic of the Geriatrics Unit of Hospital das Clínicas of Faculdade de Medicina of Universidade de São Paulo; the patients were sedentary and had not exercised regularly during the past six months. Results: Improvement of gait was seen mainly in the group that did specific exercises. Conclusion: The results of this study underline the importance of physical exercises in sedentary elderly subjects, but show the need for programming the exercises towards specific goals, which can optimize the results of this tool of health promotion for the elderly.

scholarly journals GP management of community-acquired pneumonia in Italy: the ISOCAP study

2005 ◽  
Vol 63 (1) ◽  
Author(s):  
C.M. Sanguinetti ◽  
F. De Benedetto ◽  
C.F. Donner
Keyword(s):  
Outpatient Treatment ◽  
The Elderly ◽  
Community Acquired Pneumonia ◽  
Microbiological Analysis ◽  
X Ray ◽  
Systemic Arterial Hypertension ◽  
Chest X Ray ◽  
Socioeconomic Burden ◽  
Copd Diagnosis ◽  
Observation Period

Background. Community-Acquired Pneumonia (CAP) is still a significant problem in terms of incidence, mortality rate, particularly in infants and the elderly, and socioeconomic burden. General Practitioners (GPs) are the first reference for patients with this disease, but there are few published studies regarding the outpatient treatment of CAP. Methods. The ISOCAP study aimed to identify the type and outcome of the diagnostic-therapeutic management of CAP by GPs in Italy, within the framework of developing a closer interrelationship between GPs and pulmonary specialists. Thirty-six Pulmonary Divisions throughout Italy each contacted 5 local GPs who agreed to recruit the first 5 consecutive patients who consulted them for suspected CAP within the study’s 1-year observation period. Results. A total of 183 GPs took part in the study and enrolled, by the end of the observation period, 763 CAP patients; of these, complete data was available for 737 patients [males=373, females=364, mean age (±SD) 58.8±19.6 years]. 64.4% of patients had concomitant diseases, mainly systemic arterial hypertension and COPD. Diagnosis of CAP was based by GPs on physical examination only in 41.6% of cases; in the remaining chest X-ray was also performed. In only 4.6% of patients were samples sent for microbiological analysis. All patients were treated with antibiotics: 76.7% in mono-therapy, 23.3% with a combination of antibiotics. The antibiotic class most prevalently used in mono-therapy was cephalosporin, primarily ceftriaxone; the most frequently used combinations were cephalosporin+macrolide and cephalosporin+quinolone. Mono-therapy was effective in 70% of cases, the combination of two or more antibiotics in 91.2% of patients. Overall treatment efficacy was 94.7%; hospitalisation was required in 8.5% of cases. Conclusions. Outpatient management of CAP by GPs in Italy is effective, hospitalisation being necessary only in the most severe cases due to age, co-morbidities or extent of pneumonia. This signifies a very significant savings in national health costs.

scholarly journals Community-Acquired Pneumonia Recovery in the Elderly (CAPRIE): Efficacy and Safety of Moxifloxacin Therapy versus That of Levofloxacin Therapy

2006 ◽  
Vol 42 (1) ◽  
pp. 73-81 ◽  
Author(s):  
Antonio Anzueto ◽  
Michael S. Niederman ◽  
James Pearle ◽  
Marcos I. Restrepo ◽  
Albrecht Heyder ◽  
...  
Keyword(s):  
The Elderly ◽  
Community Acquired Pneumonia ◽  
Efficacy And Safety

Community-acquired pneumonia in the elderly

2009 ◽  
pp. 111-132 ◽  
Author(s):  
V. Kaplan ◽  
S. Yende ◽  
D.C. Angus
Keyword(s):  
The Elderly ◽  
Community Acquired Pneumonia

scholarly journals Pacemaker therapy in the elderly and very elderly: comorbidity-burden vs age, as prognostic factors for excess of length of in-hospital stay, complications and mortality

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A Marschall ◽  
H Del Castillo Carnevali ◽  
F Goncalves Sanchez ◽  
M Torres Lopez ◽  
F A Delgado Calva ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Elderly Patients ◽  
Hospital Stay ◽  
The Elderly ◽  
Very Elderly ◽  
Pacemaker Therapy ◽  
Clinical Scenarios ◽  
Comorbidity Burden ◽  
The Impact ◽  
Complications And Mortality

Abstract Background The number of elderly patients undergoing pacemaker (PM) implantation is constantly growing. However, information on survival and prognostic factors of this particular patient group is scarce. Recent studies suggest that comorbidity burden may have an equal, if not greater, effect on length of in-hospital stay (LOS), complications and mortality, as age in a variety of clinical scenarios. Objective The objective of this study was to determine the survival of elderly and very elderly patients undergoing PM implantation, as well as to investigate the impact of comorbidities, as compared to age, on excess of length of in-hospital stay and mortality. Methods This is a retrospective observational study of a single centre. Patients that underwent (both elective and non-elective) PM implantation between June 2016 and December 2018 in our centre, were included for chart review. Elderly patients were defined as those with age 80–89 years, whereas very elderly patients were defined as those with ≥90 years of age. Excess in LOS was defined as an in-hospital stay >3 days. Results A total of 507 patients were included in the study with a mean age of 80.6 (±8.5) years. 255 elderly and 60 very elderly patients were included. Median follow-up time was 24 months. Baseline clinical characteristics are presented in Table 1. The mortality rate for elderly patients was 18.8% for the elderly and 36.7% for the very elderly (p=0.002). The presence of ≥2 comorbidities (defined in Table 1) resulted to be a significant predictor for the excess of LOS, whereas age did not significantly predict excess of LOS (HR: 7.1 (4.4–11.4), p<0.001); HR: 1.01 (0.9–1.1), p=0.56, respectively). Neither age, nor comorbidity burden predicted the appearance of device related complications. Both comorbidites and age predicted mortality. However, the association was stronger for the presence of comorbidites, than for age (HR: 1.9 (1.1–3.1), p=0.002 vs HR: 1.1 (1.1–1.2), p<0.001, respectively). Elderly patients with low comorbidity burden (<2 comorbidities) showed no significant differences with regards to LOS and mortality when compared to younger patients (2 (2–4) vs 3 (2–5) days, p=0.529 and 18.3% vs 17.4%, p=0.702; respectively). Conclusions Our study shows a good life expectancy of elderly and very elderly patients, that underwent PM implantation, with a survival rate that is comparable to the general population. Comorbidity burden, rather than age, significantly predicts excess of LOS and should therefore be the driving factor in the approach of patients undergoing new PM implantation. FUNDunding Acknowledgement Type of funding sources: None.

Sign in / Sign up

Export Citation Format

Share Document