At the end of the breathing tubes in your lungs are clusters of tiny air sacs. In a study of 374 patients with invasive pneumococcal disease bacteremic pneumonia, sepsis, and meningitis, 74. Often, the elderly display pneumonia symptoms differently than those who are. Pdf streptococcus pneumoniae is the most common cause of both pneumonia overall and fatal pneumonia. The webgems modules will be moved to medu and are now available via subscription if your institution created webgems assignments before september, 2016, you are grandfathered into webgems on medu and your institution will have one year free access to webgems through june, 2018. Pneumonia in elderly people is somewhat common, but some forms can be extremely dangerous. Febrile illnesses, eg, pneumonia or bladder infection, are both common and cognitively impairing. Diagnosis and management of pneumonia in older adults. The psi was not specifically designed for the elderly population, but it does give useful prognostic information. Health care industry health, general aged aged patients physiological aspects risk factors elderly elderly patients oral health management. Slide jurnal free download as powerpoint presentation. Bacterial biofilms and ongoing inflammatory responses further complicate the oral microenvironment. Pneumonia definition pneumonia is an acute infection of the parenchyma of the lung, caused. Notice webgems will no longer be available via pogoe after august 31, 2017.
Sep, 2010 malignancy and neurologic disease are associated with a high risk for death within 30 days of the recognition and management of pneumonia. Patients with nursing home acquired pneumonia nhap present a distinct group of lower respiratory track infections with different risk factors, clinical presentation, and mortality rates. Geriatric assessment and prognostic factors of mortality. Avoid antacid medications when possible studies show 4. To evaluate the diagnostic value of clinical pulmonary infection score cpis, creactive protein, and procalcitonin and to compare the accuracy of pneumonia severity scores. Pneumonia severity index port score calculate by qxmd. Revised who classification and treatment of childhood. Dysphagia, dystussia, and aspiration pneumonia in elderly. Ppt pneumonia powerpoint presentation free to download. A free powerpoint ppt presentation displayed as a flash slide show on id.
Pneumonia in the elderlydiagnosis and treatment in. Pneumonia dan influenza terdaftar sebagai urutan ke 6 dari penyebab utama kematian, dan sekitar 70% kasus pneumonia di rumah sakit terjadi pada lansia. The hypothesis of this study is that longterm outcome in elderly patients admitted with the diagnosis of communityacquired pneumonia cap or healthcareassociated pneumonia hcap would improve with a multidimensional intervention including assessment of comorbidities, nutritional, functional and cognitive status and immunization. The implications of oral health for systemic health and risk of infection are often overlooked. Pdf what is pneumonia american journal of respiratory and critical care medicine, 1931, pp.
Namirah jamshed, md, georgetown university school of medicine, amit shah, md, facp, university of texas southwestern medical school, kathryn callahan, md, wake forest university, carol howe, md,mls, university of arizona college of medicine. While most deaths are recorded in developing countries, it was the second leading cause of. Pneumonia hospitalization risk in the elderly attributable. Menurut mahmud, 2006 menyebutkan bahwa pneumonia adalah terjadinya peradangan pada salah satu atau kedua organ paru yang di sebabkan oleh infeksi. If the patient has severe communityacquired pneumonia table iii, s pneumoniae, legionella species, aerobic gramnegative bacilli especially p aeruginosa in. Pneumonia is the leading cause of morbidity and mortality in this population.
Oropharyngeal dysphagia is the major mechanism leading to aspiration pneumonia in the older adult. Pneumonia is currently classified according to the place where the patient contract the infection, such as communityacquired pneumonia, hospitalacquired pneumonia, and nursing homeacquired pneumonia, which is a part of health careassociated pneumonia. Marrie department of medicine, university of alberta, edmonton, alberta, canada pneumonia in the elderly is a common and serious problem with a clinical presentation that can differ from that in younger. Predisposing factors include chronic obstructive lung disease, lung cancer, alcoholism, influenza, congestive heart failure, multiple myeloma, chronic lymphocytic leukemia, esophageal disease. In geriatric patients, pneumococcal pneumonia symptoms are unspecified. Dysphagia, dystussia, and aspiration pneumonia in elderly people. Pneumonia, a lower respiratory tract infection that affects lung tissue, is the second leading cause of death worldwide. Since the last update of guidelines approximately 10 years ago for managing hospitalacquired pneumonia hap and ventilatorassociated pneumonia vap, new research data and treatment options for managing these conditions have emerged. Many conditions that are prevalent in the older adult population such as stroke, parkinsonism, dementia, and institutionalization have an increased incidence of oropharyngeal dysphagia. Diagnosis and management of acute pyelonephritis in adults. Geriatric assessment and prognostic factors of mortality in. Here is nanda nursing diagnosis list 20182020 in pdf free download. Geriatric medicine survival handbook the cover illustration for this revised edition depicts an inuksuk sometimes called inukshuk, a common feature of the canadian artic constructed by the inuit living there.
Pneumonia affects approximately 450 million people globally per year 7% of the population and results in about 4 million deaths. Pneumonia is second most common nursing home acquired infection. The university of akron and kent state university along with approximately 350 other college and university programs that belong to the association for gerontology in higher education offer certificates in gerontology. The graduate certificate may be received with degrees at either the specialists, masters or doctoral levels. Seniors are especially susceptible and can easily contract pneumonia in nursing home settings. Jan 23, 2014 pneumonia pneumonia is an infection in one or both of your lungs. Pneumonia is an inflammatory condition of the lung affecting primarily the small air sacs known as alveoli.
Classical presentations of pneumonia are often absent in the elderly with less chest pain, fever, chills, cough or expectoration. Ageassociated changes are risk factors in the elderly for lower respiratory tract infections. Peradangan tersebut mengakibatkan jaringan pada paru terisi oleh cairan dan tak jarang menjadi mati dan timbul abses prabu, 1996. Aspiration pneumonia in the geriatric population springerlink. Pneumonia is clinically defined as the combination of symptoms fever, chills, cough, pleuritic chest pain and signs hyper or hypothermia, increased respiratory rate, dullness upon percussion, crackles, wheezing, pleural rub associated with an opacity or opacities on a chest xray. Pneumonia in the elderly can be deadly if youre not careful. This page includes the following topics and synonyms. Types of pneumonia pneumonia affects your lungs in two ways. Marrie department of medicine, university of alberta, edmonton, alberta, canada pneumonia in the elderly is a common and serious problem with a clinical presentation that can differ from that in younger patients. If the patient has severe communityacquired pneumonia table iii, s pneumoniae, legionella species, aerobic gramnegative bacilli especially p aeruginosa in the setting of chronic lung disease. Elderly patients have an excessive incidence of nosocomial pneumonia. The curb65 calculator can be used in the emergency department setting to risk stratify a patients community acquired pneumonia. Communityacquired pneumonia in the geriatric patient free. It also is the leading reason for transfer to acutecare facilities.
Review diagnosis and management of specific infections including influenza and tuberculosis. Communityacquired pneumonia cap in the fit elderly person, which can be managed according. Even so, immobility appears to one of the most significant of the geriatric syndromes. It was developed in a large cohort of patients 14,199 inpatients and has been well validated in 38,039 inpatients and 2287 inpatients and outpatients enrolled in the pneumonia port cohort study. Aug 30, 2017 in the elderly, the incidence and prevalence of pneumonia are four times higher than that of younger population. Evaluation apache, curb65, and pneumonia severity index psi all incorporate the respiratory rate to identify the most critically ill patients. Streptococcus pneumoniae is the most common bacterial pathogen. Since points are assigned by absolute age in the psi, it may underestimate severe pneumonia in an otherwise young healthy patient. Pneumonia pneumonia is an infection in one or both of your lungs. Characterized primarily by inflammation of the alveoli in the lungs alveoli are microscopic sacs in the lungs that absorb oxygen. Successful ageing is contingent upon three elements. Also, pneumonia may temporarily decrease oxygen intake, which also hurts cognitive. Although streptococcus pneumoniae, haemophilus influenzae, enterobacteriacae, and staphylococcus aureus are the most frequently identified causative microorganisms, viruses account for up to 26% of hospital admissions for cap. These limitations have been measured in speech pathology with fiber optic endoscopic evaluation of swallowing fees examinations, but most patients with aspiration pneumonia are not studied, other than noting nonspecific signs or symptoms on the medical.
Evidence summaries contents executive summary 1 introduction 4 1. There are a few different types of pneumonia as well as different sets of symptoms. Gastrointestinal symptoms including nausea, vomiting, and diarrhoea may be found in 1520% cases of pneumococcal pneumonia. Mycoplasma pneumoniae is a rare cause of cap in elderly patients, but polymicrobic infections. Choose appropriate antibiotic therapy for pneumonia based on risk and setting. Pneumonia in the elderlydiagnosis and treatment in general. Up to 30 percent of women presenting with cystitislike symptoms have upper urinary. Gnrs6 is a concise, uptodate, and comprehensive text for advanced. Community acquired pneumonia affects 1 million elderly per year in u. Review of recent studies 2003 and 2004 concerning pneumonia in the very old.
Pneumonia is usually caused by infection with viruses or bacteria and less commonly by other. The results will be computed once all questions are answered. No related items previous article american journal of respiratory and critical care medicine. Several european medical societies convened a task force to update the guidelines, and their recommendations were reported recently in the european. Nov 14, 2012 menurut mahmud, 2006 menyebutkan bahwa pneumonia adalah terjadinya peradangan pada salah satu atau kedua organ paru yang di sebabkan oleh infeksi. A core curriculum in geriatric medicine, 10th edition grs10 is a comprehensive reference containing the latest developments in the field of geriatric medicine. In the elderly, the incidence and prevalence of pneumonia are four times higher than that of younger population. Health care industry health, general aged aged patients physiological aspects risk. Impact of a multidimensional intervention in elderly. Estimates mortality for adult patients with communityacquired pneumonia. The standard investigation for pneumonia diagnosis, chest radiography, is difficult to interpret because of nonspecific radiological findings in elderly patients and suboptimal quality of radiographs. Pneumonia is the most common cause of death among nursing home residents.
Pneumonia is an inflammation of the air sacs known as alveoli. Apr 17, 2012 why does pneumonia cause dementia like symptoms in geriatric patients, but not in younger ones. Symptoms typically include some combination of productive or dry cough, chest pain, fever and difficulty breathing. Why exactly does pneumonia cause dementia like symptoms in. Download fulltext pdf download fulltext pdf download fulltext pdf empyema thoracis article pdf available in clinical medicine insights. What causes dementia patients to behave crazy, aggressive, confused. The other bacteria which cause communityacquired pneumonia besides streptococcus pneumoniae are haemophilus infuenzae, staphylococcus. Discuss prevention interventions for elders at risk for pneumonia. It was derived based on data from 14,199 adult patients and subsequently validated on over 40,000 patients in the united states and canada. The four most important contexts or settings in which pneumonia occurs are. Aspiration pneumonia is a common infection in older adults and has a high mortality rate. Circulatory, respiratory and pulmonary medicine 41. The psychological assessment domain of comprehensive geriatric assessment cga includes four subdomains, often referred to as the 4ds. Clinical feature, risk of aspiration pneumonia in the elderly with poor oral health by access.
Create an account all fields required unless specified. Functional status, altered mental status, number of comorbidities, aspiration pneumonia, renal failure, and. Aspiration pneumonia is frequent in the elderly and occurs with increased frequency in patients with nasogastric tubes or percutaneous enterogastric tubes. What is it like to have pneumonia in an 94 yr old dementia patient who is dnr. The psiport score can be used in the clinic or emergency department setting to risk stratify a patients community acquired pneumonia. Pneumonia hazzards geriatric medicine and gerontology, 7e. If you have pneumonia, these tiny sacs become inflamed and fill up with fluid. The curb65 score includes points for confusion and blood urea nitrogen, which in the acutely ill elderly.
Pneumonia is swelling inflammation of the tissue in one or both lungs. Maintains good overall health benefits and protects against free radical damage as in cancer 5. Pneumonia is an increasingly common disease in the elderly due to an aging population. Jun 15, 2005 a major limitation in aspiration pneumonia studies to date is that the methods used to quantify swallowing problems have been poor 11, 14. Berikut ini adalah terapi empiris yang dilakukan pada pasien dengan pneumonia. Updated guidelines for management of hospitalacquired.
Comprehensive geriatric assessment cga toolkit plus. In each category of pneumonia, there is at least one. Pneumonia in the elderly, pneumonia hospitalization criteria in the elderly, pneumonia prognostic factors in older patients, pneumonia prevention in the elderly, pneumonia management in the nursing home resident, pneumonia in the nursing home. Pneumonia can be defined from three different points of view. Pneumonia is a common and often serious lower respiratory tract infection associated with considerable morbidity and mortality. This could suggest that the severity of the pneumonia might have influenced mortality more than the geriatric syndromes. Scribd adalah situs bacaan dan penerbitan sosial terbesar di dunia. Communityacquired pneumonia in the elderly thomas j. Pneumonia hazzards geriatric medicine and gerontology.
Pneumonia in older residents of longterm care facilities. American journal of respiratory and critical care medicine, 193 1, pp. Patient to be treated on an ambulatory basis previously healthy and no use of antimicrobials in the past 3 months 1. Diagnosis and management of pneumonia in older adults pogoe. While most deaths are recorded in developing countries, it was the second leading cause of death in hong kong, china, between 2012. That is, environmental or mental stressors, sleep deprivation, illness, alcohol, etc impair cognition more than these factors do in young adulthood.
Estimates mortality of communityacquired pneumonia to help determine inpatient vs. In severe aspiration pneumonia, 20% of organisms implicated are anaerobic and 80% aerobic, most of which are gramnegative enterobacteriaceae. Oct 15, 2004 pneumonia is the leading cause of morbidity and mortality in this population. It is a directional stone marker or cairn often in the shape of a. Special considerations of antibiotic prescription in the.
Hospitalization relative risk is 9 times higher for age 6579 and 25 times higher for age 80 years. Pneumonia is usually caused by infection with viruses or bacteria and less commonly by other microorganisms, certain medications. Ratarata kasus rawat inap akibat pneumonia adalah 23,1 per pada pria berusia 7584 tahun dan,3 pr pada perempuan berumur 7584 tahun. Scientific basis of who recommendations for treatment of pneumonia 6 1. Typically symptoms include some combination of productive or dry cough, chest pain, fever, and trouble breathing.
The pneumonia severity index psi is also known as the port score, port being a subset of the validation cohort. Creactive protein, procalcitonin, clinical pulmonary. Communityacquired pneumonia in the geriatric patient bibliography most elderly patients in whom communityacquired pneumonia cap develops have an identifiable risk factor. Mycobacteria often causes a chronic clinical disorder, unassociated with fever or night sweats, that resembles a pulmonary neoplasm. The oral environment is a very complex ecosystem in which a mix of anaerobic bacteria, facultative aerobes, and spirochetes compete for space and nutrients 1, 2.
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