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- Title
Characteristics of patients with community-acquired pneumococcal pneumonia.
- Authors
Padiglione, Alexander A; BSc, Jessika Willis; Bailey, Michael; Fairley, Christopher K; Padiglione, A A; Willis, J; Bailey, M; Fairley, C K
- Abstract
<bold>Objective: </bold>To describe the level of activity, independence and demographics of elderly people hospitalised with community-acquired pneumococcal pneumonia.<bold>Design: </bold>Prospective descriptive study.<bold>Setting: </bold>Seven university-affiliated hospitals and three community hospitals.<bold>Patients: </bold>People aged over 55 years admitted to hospital with a clinical history consistent with pneumococcal pneumonia, a Streptococcus pneumoniae isolate in blood or sputum, and a chest x-ray consistent with pneumonia. Significant immunosuppression or certain comorbidities (parenchymal lung disease and end-stage renal failure) were exclusion criteria.<bold>Main Outcome Measure: </bold>Level of independence, assessed by participation in a range of standardised activities before the patient's illness.<bold>Results: </bold>82 patients met our case definition. Five refused to participate, leaving 77 evaluable patients. The patients had high levels of independence: 64 (83%; 95% confidence interval [CI], 73%-91%) lived in their own home and 69 (90%; 95% CI, 81%-95%) participated in regular hobbies. Exercise tolerance was good, with 43 (56%; 95% CI, 45%-68%) able to climb a flight of stairs and 59 (76%; 95% CI, 65%-85%) able to walk more than 50 m without stopping; 41 (53%; 95% CI, 41%-64%) could continue further than a kilometre. Mortality was low (9 patients; 12%) despite a high rate of bacteraemia (43 patients; 56%). Within the past five years, 59 (77%) had been hospitalised and 53 (69%) vaccinated with influenza vaccine. Only 7% had ever received pneumococcal vaccination.<bold>Conclusion: </bold>Pneumococcal pneumonia is not the "old man's friend". It represents a major cause of morbidity and mortality in otherwise well, active and independent older Australians. Hospitalisation and attendance for influenza vaccination may represent opportunities for pneumococcal vaccination.
- Subjects
VICTORIA; PNEUMONIA diagnosis; PNEUMONIA prevention; SPUTUM microbiology; BACTEREMIA; RESEARCH; RESEARCH methodology; ACTIVITIES of daily living; EVALUATION research; MEDICAL cooperation; STREPTOCOCCUS; COMPARATIVE studies; COMMUNITY-acquired infections; HOSPITAL care
- Publication
Medical Journal of Australia, 1999, Vol 170, Issue 4, p165
- ISSN
0025-729X
- Publication type
journal article
- DOI
10.5694/j.1326-5377.1999.tb127713.x