Out-hospital pneumonia (OHP) is one of the most distributed diseases of respiratory organs. Significant factor of risk development is the elderly age.
The aim of investigation is to analyse and clear up the clinical peculiarities of course of out-hospital pneumonia among elderly patients.
Material and methods. There were observed 229 patients of elderly age (60-74) with OHP. The patients with severe damage of internal organs were not included in the group of investigation. The verification of diagnosis was made on the base of clinico-laboratory methods of investigation, according to diagnostic standards in treating patients with pneumonia. Dynamic observation, complex laboratory and instrumental-functional investigation were done in conditions of curative-prophylactic institutions of Astrakhan.
Results of investigation. The bacteriologic investigation gave the possibity to find etiologic factor of OHP in all 229 patients. Identificated excitors were distributed in the following type: Streptococcus pneumoniae - 35,2%, Haemophilus influenzae - 23,8%, Staphylococcus aureus - 4,8%, Enterobacteriaceae - 7,6%, association of gram-positive and gram-negative flora in 28,1% cases. Given results were coordinated with literary data about etiology of pneumonia in persons of elderly age groups. Pneumonia was confirmed in all patients roentgen logically. 120 patients showed low lobe pneumonia, 75 right side, 39 - left side localization. 70 patients showed upper lode right side pneumonia, 35 - by-side low lobe pneumonia.
The analysis of course of disease in 229 observed patients of elderly age with OHP found out the clinical peculiarities of the following types: slight expression of symptoms, difficulty in determination of nature during percussion of parts in lungs, frequent absence of acute onset of disease, frequency and expression of disturbances of central nervous system (mixture of consciousness, slow reaction, disorientation), weak general condition, decrease of physical activity, losing of capabilities of self-service, appearance to the first front of symptoms in superficial diseases in clinical picture, prolong resorption of lung infiltration, difficultiens in making differentiated diagnosis between first and second character of pneumonia. «Gold standard» in diagnostics of pneumonia: fever, cough, sputum, leucocytosis, lung infiltration, all of them were found out in 47% of cases among elderly patients, it was lower than in patients of young age (difference is significant statistically, 95% of proving). Among patients of elderly age the OHP was in 37,4% in patients with elderly age. Bed-day in patients of elderly age was 24,4 days, in young persons - 15,2/
Received data showed the necessity of careful care to verification of diagnosis in case with OHP in persons of elderly age.
The work was submitted to international scientific conference «Present-day problems of experimental and clinical medicine», Thailand - Cambodia, February 18-28, 2009. Came to the editorial office on 22.01.2009.