Clinical courses of elderly patients with community-treated pneumonia: A retrospective cohort in Northern Israel

A BSTRACT Background: This retrospective cohort study investigates the clinical course of elderly patients with community-acquired pneumonia (CAP) aged 75 and above. The study focuses specifically on the outcomes of outpatient treatment as an alternative to hospitalization, which poses inherent risks for this vulnerable population. Methods: The study, conducted between 2016 and 2018, scrutinized data from 165 CAP cases of patients aged 75 and above, drawn from seven primary care clinics in northwestern Israel. The dataset encompassed various variables, including demographic details, functional status, comorbidities, clinical presentations, and treatment regimens. Results: As opposed to previous reports, the study revealed encouragingly low 30-day mortality and hospitalization rates of 3% and 13%, respectively, among the cohort receiving managed outpatient care. Further analysis revealed that chest X-rays were conducted in approximately 57% of cases, with pathological findings identified in 68% of those who underwent imaging. Additionally, certain factors emerged as potential predictors of poorer outcomes, including advanced age, functional impairment, and diagnosis during a home visit rather than in a clinic setting. Conclusions: These findings shed light on the nuanced challenges and considerations in managing pneumonia among elderly patients in outpatient settings. Notably, the study underscores the need for continued research and evaluation in this area to optimize care delivery and mitigate risks associated with hospitalization, ultimately enhancing the overall management of CAP in the elderly population.