Clinical Analysis Of101Elderly Cases Of Aspiration Pneumonia

Background: When an aging population has become the world trend, greaterattention has been given to the health of the elderly by more and more people. It isreported that the pneumonia-associated deaths are the4th leading cause of death inelderly people. And aspiration pneumonia is associated with a high morbidity andmortality in elderly patients. Studies have shown that, about45%of the elderly willoccur aspiration in sleep (including silent aspiration), but the fatality rate of thepneumonia caused by aspiration accounts for one-third of all the mortaility of thepneumonia. So how to decrease the incidence and mortality of aspiration pneumonia inthe elderly, increase the diagnosis and cure rate,delay the process of the disease andenhance the quality of life of the aged have important clinical significance.Objective：This paper aims to sum up the clinical features, diagnosis, treatmentand prognosis of aspiration pneumonia in the elderly and analysis the risk factors,whichdesigned to improve early diagnosis,early treatment for the purpose of well outcomesinvolved prognosis and life condition.Methods：This paper retrospectively analysis101cases of elderly in-patients,whohas been diagnosed aspiration pneumonia in the first Affiliated Hospital of DalianMedical University from January2006to July2011.Clinical data were collected andanalysised,including comorbid illness, clinical characters,laboratoryexaminations,revealing infiltration in the lung fields on chest radiograph and computedtomographic images and so on.Results:1. Comorbidities: Among the101cases,98patients (97%)had at least onecomorbidity,and there were89cases suffered originally from more than two otherdiseases,which accounted for88.1%. Among them, the patients who had a history ofcardiac disease or cerebrovascular disease were the most. 2. Clinical features: In elderly patients, bedridden were more. Eighty-one (80.2%)of the patients were bedridden. As the main performers listlessness and loss of appetiteeach89.1%、86.1%,while there were respectively58.4%、48.5%patients mainly behavedas cough and purulent sputum.93.1%of patients showed wet or dry rales. Signs ofpulmonary consolidation were fewer,only14cases (13.9%) had reduced breath sounds.3.Laboratory examinations: In48cases(47.5%),white blood cell countincreased,while the percentage of neutrophils increased in69cases(68.3%).4. In the101in-patients,78cases had arterial blood gas analysis,as type1respiratory failure25cases (32.1%), type2respiratory failure only7cases (8.9%), theremaining46cases (60.0%)were normal.5.There were71patients underwent a sputum culture,57patients sputum cultureresult is positive (80.3%),and the rest for the negative.Sputum culture results showedthat mixed infection rates high,two or more than two pathogens infections were41cases(57.7%),and31patients(43.7%) with fungal infection.Gram-negative bacteria(58cases,81.75%) is the main pathogenic bacteria.Amongethem, the most is Klebsiella pneumoniae,which were isolated from17patients(23.9%),followed by Acinetobacter baumannii (11cases,15.5%)、 Pseudomonasaeruginosa(7cases,9.9%),and Pseudomonas maltophilia(7cases,9.9%). Inaddition,aureus (including Staphylococcus aureus、 Staphylococcus epidermidis、Hemolytic staphylococcus、People staphylococcus)infection made up32.4%(23cases).Fungal infections mainly were Candida albicans(20cases,28.2%).6. Imaging: All the patients had lung imaging examination,among them,23patients (22.8%) had radiographic examination,the others (77.2%) had computedtomographic images. Those who only behaved as increased lung markings were totally26cases (25.7%),and performance of bronchial pneumonia-like changes in75cases(74.3%). In which happened in right lung takes in under leaves accounted for36.6%(37cases),and the left lung lower lobe in10patients (9.9%) as the mainperformance.Bilateral lung,were28cases(23.8%).7. Outcomes:17patients (16.8%) were cured, while25cases (24.8%) weredied,the conditions of the rest59cases (58.4%) were improved.Conclusion: Aspiration pneumonia of the elderly with untypical clinical symptomand high mortality rate,low cure rate,which mainly requires comprehensive therapies.