There is an opinion that the etiology, clinical picture and prognosis of pneumonia developing in people living in nursing homes differ from those of other patient groups. However, the number of studies supporting this hypothesis is limited.

In a prospective study by E. Martinez-Moragon et al. (Spain) from 2002 to 2003. Clinical and laboratory parameters were studied and compared in elderly patients (over 65 years) hospitalized for community-acquired pneumonia. Particular attention was paid to the functional state of the patients, determined using the Eastern Joint Oncology Group (ECOG) scale and Barthel and Karnofsky indices, as well as to the presence of concomitant pathologies. To determine the agents responsible for the infection, a double blood culture test was carried out, a test for the detection of the Legionella antigen in the urine and serological tests for the detection of atypical microorganisms; in some cases, a sputum culture test was performed.

The study included data from 91 patients, 25 of whom resided in nursing homes. It should be noted that the residents of nursing homes were older (mean age 82 ± 4 vs 73 ± 5; p = 0.0001), suffered more often from concomitant pathologies, in particular from diabetes. sweet, cardiovascular heart disease, congestive heart failure and dementia (p = 0.0001), and had lower indicators of functional status (on the ECOG scale 2.09 ± 0.9 vs 0.93 ± 1.1, p = 0.001; Bartel index 19 ± 33 vs 77 ± 35, p = 0.001; Karnofsky index 51 ± 17 vs 78 ± 23, p = 0.001).

A closer examination showed a more severe nature of the course of the infection process in patients living in nursing homes. So in this category of patients:

There were no significant differences in the etiology of pneumonia, which may however be due to the low frequency of detection of the causative agent of the infection. According to the results of the step-by-step logistic regression, a significant prognostic criterion for the onset of death in the elderly in this study was a high level of serum urea.

Thus, in the study population, residents of nursing homes belonged to the older age group, had a higher incidence of concomitant pathology and severe functional impairment, which predisposed to a severe course of pneumonia with a mortality rate. higher, although the etiology of the process does not differ significantly from that of other patients with this pathology.