Perfil clínico y epidemiológico de adultos mayores hospitalizados por infecciones adquiridas en la comunidad
Palabras clave:
anciano, infecciones comunitarias adquiridas, hospitalización, evolución clínica
Resumen
Introducción: las enfermedades infecciosas son una de las principales causas de hospitalización y mortalidad en adultos mayores, y con el crecimiento de la población geriátrica, también aumenta la carga de estas enfermedades y surge la necesidad de caracterizar a los mismos.
Objetivos: determinar las características clínicas y epidemiológicas de los pacientes adultos mayores hospitalizados por enfermedades infecciosas en el Hospital de Policía Rigoberto Caballero durante el 2024.
Metodología: estudio observacional descriptivo, transversal, retrospectivo, con muestreo no probabilístico por conveniencia. La muestra se constituyó con hombres y mujeres con edad ≥60 años, internados por enfermedades infecciosas en el servicio de clínica médica. Se aplicó estadística descriptiva.
Resultados: se evaluaron 82 pacientes con una media de edad de 73 ± 6 años, predominando el sexo masculino (58,53%). Las principales comorbilidades fueron hipertensión arterial (86,58%) y diabetes mellitus tipo 2 (53,65%). Los motivos de consulta más frecuentes fueron dificultad respiratoria (21,95%), decaimiento general (18,29%) y fiebre (17,07%). Las infecciones más comunes fueron neumonía adquirida en la comunidad (28,04%), infecciones urinarias (24,39%) e infecciones de piel y partes blandas (18,29%). El promedio de internación fue de 11,06 días. Fueron tratados con una media de 2 antibióticos por paciente. Las cefalosporinas se utilizaron en el 69,51%. El 93,9% fue dado de alta y 6,09% requirió traslado a cuidados intensivos.
Conclusión: los adultos mayores hospitalizados por infecciones evidencian alta comorbilidad, diagnósticos de neumonía e infecciones urinarias, uso de cefalosporinas y evolución clínica favorable.
Citas
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2. Prince MJ, Wu F, Guo Y, Gutierrez Robledo LM, O'Donnell M, Sullivan R, Yusuf S. The burden of disease in older people and implications for health policy and practice. Lancet [Internet] 2015 [cited 2025 Jun 27]; 385(9967):549–62. Available from: https://pubmed.ncbi.nlm.nih.gov/25468153/ Subscription required
3. Vitali A, Dini S, Cozza M, Gianturco V, Brunori M, Mazza L. Sepsis and septic shock in geriatrics. Geriatric Care [Internet] 2024 [cited 2026 Enero 26]. Available from: https://www.pagepressjournals.org/gc/article/view/11709/12562
4. Huang Y, Li S, Ye W, Wang H, Su J, Gao L, et al. Viral infections in elderly individuals: A comprehensive overview of SARS-CoV-2 and influenza susceptibility, pathogenesis, and clinical treatment strategies. Vaccines (Basel) [Internet]. 2025 [cited 2025 Jun 27]; 13(4):431. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC12031201/
5. Han JH, Resser JJ, Baughman A, Grijalva CG, Johnson J, Miller KF, et al. Community-acquired pneumonia in hospitalized adults: long-term morbidities and their risk factors. BMC Infect Dis [Internet]. 2025 [cited 2025 Oct 27];25(1): 826. Available from: https://pubmed.ncbi.nlm.nih.gov/40597744/
6. Yoshikawa TT, Norman DC. Geriatric infectious diseases: Current concepts on diagnosis and management. J Am Geriatr Soc [Internet]. 2017 [cited 2025 Jun 12]; 65(3):631-41. Available from: https://pubmed.ncbi.nlm.nih.gov/28140454/
7. Ibarz M, Haas LEM, Ceccato A, Artigas A. The critically ill older patient with sepsis: a narrative review. Ann Intensive Care [Internet]. 2024 [cited 2025 Jun 24]; 14(1):6. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10781658/
8. Falcone M, Tiseo G. Skin and soft tissue infections in the elderly. Curr Opin Infect Dis [Internet]. 2023 [cited 2025 Jun 27]; 36(2):102-8. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC10325572/
9. Dülger D, Ture Z, Yolcu A, Eren EE, Sanlier N, Alp E. Sepsis in elderly patients: investigation of prognostic factors in a secondary healthcare facility. BMC Infect Dis [Internet]. 2025 [cited 2025 Oct 24];25(1):907. Available from: https://pubmed.ncbi.nlm.nih.gov/40640725/
10. Artero A, López-Cruz I, Aguilera JA, Piles L, Artero S, Eiros JM. et al. Recurrent urinary tract infections in older adults requiring hospitalization in an internal medicine ward. Microorganisms [Internet]. 2024 [cited 2026 Enero 15]; 12(11): 2114. Available from: https://www.mdpi.com/2076-2607/12/11/2114
11. Elmotia K, Abouyaala O, Bougrine S, Ouahidi ML. Geriatric syndromes in older adults with and without diabetes: A systematic review and meta-analysis. Res Gerontol Nurs [Internet]. 2025 [cited 2025 Ago 20];18(2):99-108. Available from: https://pubmed.ncbi.nlm.nih.gov/39874547/
12. Pazan F, Wehling M. Polypharmacy in older adults: a narrative review of definitions, epidemiology and consequences. Eur Geriatr Med [Internet]. 2021 [cited 2026 Apr 4];12(3):443-52. Available from: https://pubmed.ncbi.nlm.nih.gov/33694123/
13. Regueiro M, Homar C, Ovejero R, Liu A, Pieroni T, Basilico R. Características clínicas y valoración geriátrica en adultos mayores con neumonía de un hospital de Buenos Aires, Argentina. Rev. perú. med. exp. salud publica [Internet]. 2013 [citado 20 Ago 2025]; 30(3):432-36. Disponible en: http://www.scielo.org.pe/scielo.php?script=sci_arttext&pid=S1726-46342013000300010&lng=es&nrm=iso&tlng=es
14. Freire Sampaio LB, Araújo Moreira AC, Silva de Oliveira FE, Teixeira IX, Frota Goyanna N, Pereira Sousa VL. Perfil epidemiológico e clínico de idosos hospitalizados no setor de emergência. Enferm Foco [Internet]. 2020 [citado 28 Jun 2025]; 11(3): 161-9. Disponible en: https://enfermfoco.org/wp-content/uploads/articles_xml/2357-707X-enfoco-11-03-0161/2357-707X-enfoco-11-03-0161.pdf
15. Camerino-Hernandez E, Gutierrez-Gómez T, Peñarrieta-De Cordova M, Piñones-Martinez M. Caracterización del adulto mayor hospitalizado: un estudio retrospectivo. Rev enferm Herediana [Internet]. 2016 [citado 28 Jun 2025];9(1):36. Disponible en: https://revistas.upch.edu.pe/index.php/RENH/article/view/2861
16. Hoffman T, Margalit I, Tabah A, Ruckly S, Barbier F, Singer P, et al. Risk factors for mortality among older adults with hospital-acquired bloodstream infections in the intensive care unit: A multicenter cohort study. Infect Dis Ther. [Internet]. 2025 [cited 2025 Jun 24];14(2): 483–92. Available from: https://pubmed.ncbi.nlm.nih.gov/39794673/
17. Chenhuichen Ch, Marín-Epelde I, Ramón-Espinoza F, Sánchez-Latorre M, Gonzales Montejo NJ, Pozo Vico A. et al. Características epidemiológicas, clínicas y funcionales de los pacientes mayores de 75 años ingresados en un hospital terciario durante la primera ola pandémica por SARS-CoV-2. Rev Esp Geriatr Gerontol [Internet]. 2024 [citado 28 Jun 2025]; 59(2): 101449. Disponible en: https://pubmed.ncbi.nlm.nih.gov/38064873/
18. Rodríguez M, Plaza S, Alvarez M. Caracterización del paciente geriátrico en la unidad de cuidados intermedios. Revista Ciencias Médicas La Habana [Internet]. 2020 [citado 28 Jun 2025]; 27(3):299-311. Disponible en: https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=98950
19. Pulia M, Griffin M, Schwei RJ, Pop-Vicas A, Schulz L, Shieh MS, et al. National trends in antibiotic prescribing for adults hospitalized with coronavirus disease 2019 and other viral respiratory infections. Open Forum Infect Dis [Internet]. 2025 [cited 2025 Jun 1];12(2) :ofaf045. Available from: https://pubmed.ncbi.nlm.nih.gov/39963703/
20. Pneumonia: diagnosis and management. London: National Institute for Health and Care Excellence (NICE); 2025. (NICE Clinical Guidelines, No. 250). [cited 2025 Jun 1]. Available from: https://pubmed.ncbi.nlm.nih.gov/41264741/
21. Ewig S, Kolditz M, Pletz M, Altiner A, Albrich W, Drömann D, et al. [Management of adult community-acquired pneumonia and prevention - update 2021 - Guideline of the German Respiratory Society (DGP), the Paul-Ehrlich-Society for Chemotherapy (PEG), the German Society for Infectious Diseases (DGI), the German Society of Medical Intensive Care and Emergency Medicine (DGIIN), the German Viological Society (DGV), the Competence Network CAPNETZ, the German College of General Practitioneers and Family Physicians (DEGAM), the German Society for Geriatric Medicine (DGG), the German Palliative Society (DGP), the Austrian Society of Pneumology Society (ÖGP), the Austrian Society for Infectious and Tropical Diseases (ÖGIT), the Swiss Respiratory Society (SGP) and the Swiss Society for Infectious Diseases Society (SSI)]. Pneumologie [Internet]. 2021 [cited 2025 Jul 4]; 75(9):665-729. Available from: https://pubmed.ncbi.nlm.nih.gov/34198346/#full-view-affiliation-3
