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The outcome of pneumonia in the elderly: a hospital survey

We studied the premorbid characteristics and outcomes of 73 consecutive elderly patients (median age 79 years) admitted to hospital with community-acquired pneumonia. Eighty-six per cent of all patients had previously suffered from chronic diseases (mainly respiratory), 54% had been restricted in outdoor mobility due to breathlessness and 22% had limited self-care ability (Barthel score 15/20 or less). By six weeks 33% had died. Amongst the 49 survivors, nine patients (18%) were in hospital and eight had required a change of residence on discharge indicating a greater level of dependency. Fourteen of these 17 patients had previously lived alone. Amongst those who had returned to private addresses, the prevalence of significant disability (Barthel score 15/20 or less) rose from 20% before the pneumonia to 30% at six weeks. Amongst the less disabled survivors, the perceived health, measured by the Nottingham Health Profile, was similar to that found in a community survey of chronically ill elderly people. In addition to a high fatality rate, community acquired pneumonia in the elderly carries a substantial morbidity in terms of increased dependency and disability.