Some aspects of pneumonia in elderly patients with chronic obstructive pulmonary disease (based on analysis of postmortem examination)

Abstract

Forty-six medical histories and autopsy protocols of died elderly and senile patients with chronic respiratory diseases treated in a pulmonology department of Saint-Petersburg War Veterans' hospital in 1997 were analyzed. Their average age was 76.76 yrs. There were 39 (84.78 %) males and 7 (15.22 %) females. COPD as basic, co-existing or underlying pathology was found during the autopsy in 43 of 46 died patients (93.48 %). The postmortem examination revealed 21 pneumonia cases considering as complications. Pneumonia complicating the basic COPD were registered in 14 patients (66.67 %), pneumonia complicating carcinoma in underlying COPD were detected in 7 (33.33 %) of the patients. Most pneumonias were community-acquired (85.71 %) and only 3 ones were nosocomial (14.29%). Pneumonic foci in COPD patients was prevalently smallsized (38.10%) or local (33.33 %) and situated in lower lung fields (85.72 %), mostly in the right lung (42.86 %). COPD and pneumonia combined in elderly and senile patients should be considered as mutually aggravating diseases. Pneumonia in elderly as a threatening complication can cause a poor outcome and, on the other hand, it often results in COPD exacerbation and death.