Neumonía en el anciano mayor de 80 a？os con ingreso hospitalario

objetive: to analize and compare differences in patients older than 80 years with community acquired pneumonia admitted in internal medicine or pneumology of a general hospital from the emergency room. material and methods: retrospective study of all the 277 patients above 80 years admitted into the hospital in 2005 with the main diagnosis of pneumonia. results: 84% community-acquired, 16% from institutions. mean age: 85.8 y (48% men, 52% women). 19% fine-3, 49% fine-4, 32% fine-5. known etiology: 25% (pneumococcal 19%, h. influenzae and other gram (-) 6%. 75% treated by internists, 22% treated by pneumologists. standard guidelines followed up by 30,5% a variant 60% (equal by internists or pneumologists). time door-1st antibiotic dose 6.6 hours. global mortality 16.7%. women died at 87.4 y, men at 84.5 y (p = 0.035). mortality fine 3-4-5: 4.5, 12.4, 30% respectively. mortality treated before 4 hours: 34.6%, after 4 hours: 11.5% (p = 0.01). many more fine 5 cases in int. medicine than pneumology. mortality by internists 22%. mortality by pneumologists 3% (p = 0.001). mortality similar following strict guidelines or variant. conclusions: a) internist receive patients sicker than pneumologists; b) important mortality in these very old patients of 16.7%, and progressive according the fine severiy index, in spite of correct therapy; c) rapid initiation of antibiotics did not decreased mortality; d) mortality did not change following strict or variant guidelines; and e) there are areas of quality improvement in our hospitals.