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Chapter 22 - Pulmonary Issues

from Section III - Care of the Elderly by Organ System

Published online by Cambridge University Press:  30 June 2022

Jan Busby-Whitehead
Affiliation:
University of North Carolina, Chapel Hill
Samuel C. Durso
Affiliation:
The Johns Hopkins University, Maryland
Christine Arenson
Affiliation:
Thomas Jefferson University, Philadelphia
Rebecca Elon
Affiliation:
The Johns Hopkins University School of Medicine
Mary H. Palmer
Affiliation:
University of North Carolina, Chapel Hill
William Reichel
Affiliation:
Georgetown University Medical Center
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Summary

Older adults are disproportionately affected by many chronic lung diseases. Numerous normal physiologic changes occur in the lungs with age, from reduced parenchymal elastic recoil to thoracic cage distortion. These changes impact pulmonary pathophysiology and disease diagnosis. Clinicians should be cognizant of geriatric issues that can impact diagnosis, treatment, and the occurrence of adverse events secondary to treatment. For example, multimorbidity, the co-occurrence of multiple comorbidities, is more common with increasing age. Additionally, people with chronic lung diseases have a higher burden of geriatric syndromes, such as frailty, functional impairment, falls, and social isolation. Older adults are at increased risk of severe morbidity from acute lung conditions such as pneumonia and pulmonary embolism. Treatment of older patients in the intensive care unit requires special attention to geriatric issues (called “age-friendly care”) that will improve the quality of their care. This chapter reviews the natural history of pulmonary system aging, discusses the most commonly encountered chronic lung diseases with aging, and briefly examines special issues with caring for older adults in a critical care setting.

Type
Chapter
Information
Reichel's Care of the Elderly
Clinical Aspects of Aging
, pp. 270 - 285
Publisher: Cambridge University Press
Print publication year: 2022

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References

Janssens, J-P, Pache, J-C, Nicod, L. Physiological changes in respiratory function associated with ageing. European Respiratory Journal. 1999; 13(1):197205.CrossRefGoogle ScholarPubMed
Janssens, J-P. Aging of the respiratory system: Impact on pulmonary function tests and adaptation to exertion. Clinics in Chest Medicine. 2005; 26(3):469484.Google Scholar
Edge, JR, Millard, FJC, Reid, L, Simon, G. The radiographic appearances of the chest in persons of advanced age. BJR. 1964; 37(442):769774. doi: 10.1259/0007-1285-37-442-769.Google Scholar
Estenne, M, Yernault, JC, De Troyer, A. Rib cage and diaphragm-abdomen compliance in humans: Effects of age and posture. J Appl Physiol. 1985; 59(6):18421848. doi: 10.1152/jappl.1985.59.6.1842.Google Scholar
Bode, FR, Dosman, J, Martin, RR, Ghezzo, H, Macklem, PT. Age and sex differences in lung elasticity, and in closing capacity in nonsmokers. Journal of Applied Physiology. 1976; 41(2):129135. doi: 10.1152/jappl.1976.41.2.129.Google Scholar
Polkey, MI, Harris, ML, Hughes, PD, et al. The contractile properties of the elderly human diaphragm. Am J Respir Crit Care Med. 1997; 155(5):15601564. doi: 10.1164/ajrccm.155.5.9154857.Google Scholar
Vaz Fragoso, CA, McAvay, G, Van Ness, PH, et al. Phenotype of normal spirometry in an aging population. Am J Respir Crit Care Med. 2015; 192(7):817825. doi: 10.1164/rccm.201503-0463OC.Google Scholar
Luoto, JA, Elmståhl, S, Wollmer, P, Pihlsgård, M. Incidence of airflow limitation in subjects 65–100 years of age. Eur Respir J. 2016; 47(2):461472. doi: 10.1183/13993003.00635-2015.Google Scholar
Crapo, RO, Jensen, RL, Hegewald, M, Tashkin, DP. Arterial blood gas reference values for sea level and an altitude of 1,400 meters. Am J Respir Crit Care Med. 1999; 160(5 Pt 1):15251531. doi: 10.1164/ajrccm.160.5.9806006.Google Scholar
Hardie, JA, Vollmer, WM, Buist, AS, Ellingsen, I, Mørkve, O. Reference values for arterial blood gases in the elderly. Chest. 2004; 125(6):20532060. doi: 10.1378/chest.125.6.2053.Google Scholar
Svartengren, M, Falk, R, Philipson, K. Long-term clearance from small airways decreases with age. European Respiratory Journal. 2005; 26(4):609615. doi: 10.1183/09031936.05.00002105.Google Scholar
Sura, L, Madhavan, A, Carnaby, G, Crary, MA. Dysphagia in the elderly: Management and nutritional considerations. Clin Interv Aging. 2012; 7:287298. doi: 10.2147/CIA.S23404.Google Scholar
Centers for Medicare and Medicaid Services. Chronic Conditions among Medicare Beneficiaries, Chartbook, 2012 edition. Baltimore, MD, 2012, 11:1521.Google Scholar
Gs, S, Pj, B, Ss, B, et al. An official American Thoracic Society workshop report: Evaluation and management of asthma in the elderly. Ann Am Thorac Soc. 2016; 13(11):20642077. doi: 10.1513/annalsats.201608-658st.Google Scholar
Pfeifer, MA, Weinberg, CR, Cook, D, Best, JD, Reenan, A, Halter, JB. Differential changes of autonomic nervous system function with age in man. Am J Med. 1983; 75(2):249258. doi: 10.1016/0002-9343(83)91201-9.Google Scholar
Postma, DS, Rabe, KF. The asthma-COPD overlap syndrome. N Engl J Med. 2015; 373(13):12411249. doi: 10.1056/NEJMra1411863.Google Scholar
Miravitlles, M, Soriano, JB, Ancochea, J, et al. Characterisation of the overlap COPD-asthma phenotype: Focus on physical activity and health status. Respir Med. 2013; 107(7):10531060. doi: 10.1016/j.rmed.2013.03.007.Google Scholar
Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease. 2020. https://goldcopd.org/wp-content/uploads/2019/12/GOLD-2020-FINAL-ver1.2-03Dec19_WMV.pdf.Google Scholar
Lozano, R, Naghavi, M, Foreman, K, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: A systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012; 380(9859):20952128. doi: 10.1016/S0140-6736(12)61728-0.Google Scholar
Qaseem, A, Wilt, TJ, Weinberger, SE, et al. Diagnosis and management of stable chronic obstructive pulmonary disease: A clinical practice guideline update from the American College of Physicians, American College of Chest Physicians, American Thoracic Society, and European Respiratory Society. Ann Intern Med. 2011; 155(3):179191. doi: 10.7326/0003-4819-155-3-201108020-00008.Google Scholar
Nici, L, Mammen, MJ, Charbek, E, et al. Pharmacologic management of chronic obstructive pulmonary disease: An official American Thoracic Society clinical practice guideline. Am J Respir Crit Care Med. 2020; 201(9):e56e69. doi: 10.1164/rccm.202003-0625ST.Google Scholar
Kohansal, R, Martinez-Camblor, P, Agustí, A, Buist, AS, Mannino, DM, Soriano, JB. The natural history of chronic airflow obstruction revisited: An analysis of the Framingham offspring cohort. Am J Respir Crit Care Med. 2009; 180(1):310. doi: 10.1164/rccm.200901-0047OC.CrossRefGoogle ScholarPubMed
Warnier, MJ, van Riet, EES, Rutten, FH, De Bruin, ML, Sachs, APE. Smoking cessation strategies in patients with COPD. Eur Respir J. 2013; 41(3):727734. doi: 10.1183/09031936.00014012.Google Scholar
Rigotti, NA. Smoking cessation in patients with respiratory disease: Existing treatments and future directions. The Lancet Respiratory Medicine. 2013; 1(3):241250. doi: 10.1016/s2213-2600(13)70063-8.CrossRefGoogle ScholarPubMed
Puhan, MA, Gimeno‐Santos, E, Scharplatz, M, Troosters, T, Walters, EH, Steurer, J. Pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease. The Cochrane Library. Published 2011.Google Scholar
Kesten, S, Casaburi, R, Kukafka, D, Cooper, CB. Improvement in self-reported exercise participation with the combination of tiotropium and rehabilitative exercise training in COPD patients. Int J Chron Obstruct Pulmon Dis. 2008; 3(1):127136. doi: 10.2147/copd.s2389.Google Scholar
Casaburi, R, Kukafka, D, Cooper, CB, Witek, TJ, Kesten, S. Improvement in exercise tolerance with the combination of tiotropium and pulmonary rehabilitation in patients with COPD. Chest. 2005; 127(3):809817. doi: 10.1378/chest.127.3.809.Google Scholar
McCarthy, B, Casey, D, Devane, D, Murphy, K, Murphy, E, Lacasse, Y. Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2015; 2:CD003793. doi: 10.1002/14651858.CD003793.pub3.Google Scholar
Spruit, MA, Singh, SJ, Garvey, C, et al. An official American Thoracic Society/European Respiratory Society statement: Key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med. 2013; 188(8):e13e64. doi: 10.1164/rccm.201309-1634ST.Google Scholar
Lindenauer, PK, Stefan, MS, Pekow, PS, et al. Association between initiation of pulmonary rehabilitation after hospitalization for COPD and 1-year survival among Medicare beneficiaries. JAMA. 2020; 323(18):18131823. doi: 10.1001/jama.2020.4437.Google Scholar
Moscovice, IS, Casey, MM, Wu, Z. Disparities in geographic access to hospital outpatient pulmonary rehabilitation programs in the United States. Chest. 2019; 156(2):308315. doi: 10.1016/j.chest.2019.03.031.Google Scholar
Robinson, SA, Shimada, SL, Quigley, KS, Moy, ML. A web-based physical activity intervention benefits persons with low self-efficacy in COPD: Results from a randomized controlled trial. Journal of Behavioral Medicine. 2019:19.Google Scholar
Cook, H, Reilly, CC, Rafferty, GF. A home-based lower limb-specific resistance training programme for patients with COPD: An explorative feasibility study. ERJ Open Res. 2019; 5(2). doi: 10.1183/23120541.00126-2018.Google Scholar
Cranston, JM, Crockett, A, Moss, J, Alpers, JH. Domiciliary oxygen for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2005; 2005(4). doi: 10.1002/14651858.CD001744.pub2.Google Scholar
Bekkat-Berkani, R, Wilkinson, T, Buchy, P, et al. Seasonal influenza vaccination in patients with COPD: a systematic literature review. BMC Pulm Med. 2017; 17. doi: 10.1186/s12890-017-0420-8.Google Scholar
Tanoue, LT, Tanner, NT, Gould, MK, Silvestri, GA. Lung cancer screening. Am J Respir Crit Care Med. 2015; 191(1):1933. doi: 10.1164/rccm.201410-1777 CI.Google Scholar
Brenner, AT, Malo, TL, Margolis, M, et al. Evaluating shared decision making for lung cancer screening. JAMA Intern Med. 2018; 178(10):13111316. doi: 10.1001/jamainternmed.2018.3054.Google Scholar
Sethi, S, Murphy, TF. Infection in the pathogenesis and course of chronic obstructive pulmonary disease. N Engl J Med. 2008; 359(22):23552365. doi: 10.1056/NEJMra0800353.Google Scholar
Hoogendoorn, M, Hoogenveen, RT, Rutten-van Mölken, MP, Vestbo, J, Feenstra, TL. Case fatality of COPD exacerbations: a meta-analysis and statistical modelling approach. Eur Respir J. 2011; 37(3):508515. doi: 10.1183/09031936.00043710.Google Scholar
Walters, JAE, Tan, DJ, White, CJ, Gibson, PG, Wood-Baker, R, Walters, EH. Systemic corticosteroids for acute exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2014; 9:CD001288. doi: 10.1002/14651858.CD001288.pub4.Google Scholar
Vollenweider, DJ, Frei, A, Steurer-Stey, CA, Garcia-Aymerich, J, Puhan, MA. Antibiotics for exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2018; 10:CD010257. doi: 10.1002/14651858.CD010257.pub2.Google Scholar
Fried, TR, Vaz Fragoso, CA, Rabow, MW. Caring for the older person with chronic obstructive pulmonary disease. JAMA. 2012; 308(12):12541263. doi: 10.1001/jama.2012.12422.Google Scholar
Keam, SJ, Keating, GM. Tiotropium bromide: A review of its use as maintenance therapy in patients with COPD. Treat Respir Med. 2004; 3(4):247268. doi: 10.2165/00151829-200403040-00005.Google Scholar
Kesten, S, Jara, M, Wentworth, C, Lanes, S. Pooled clinical trial analysis of tiotropium safety. Chest. 2006; 130(6):16951703. doi: 10.1378/chest.130.6.1695.CrossRefGoogle ScholarPubMed
Suissa, S, Assimes, T, Ernst, P. Inhaled short acting β agonist use in COPD and the risk of acute myocardial infarction. Thorax. 2003; 58(1):4346. doi: 10.1136/thorax.58.1.43.Google Scholar
Calverley, PMA, Stockley, RA, Seemungal, TAR, et al. Reported pneumonia in patients with COPD: Findings from the INSPIRE study. Chest. 2011; 139(3):505512. doi: 10.1378/chest.09-2992.Google Scholar
Niewoehner, DE, Erbland, ML, Deupree, RH, et al. Effect of systemic glucocorticoids on exacerbations of chronic obstructive pulmonary disease. New England Journal of Medicine. 1999; 340(25):19411947. doi: 10.1056/NEJM199906243402502.Google Scholar
Sanchis, J, Gich, I, Pedersen, S, Aerosol Drug Management Improvement Team (ADMIT): Systematic review of errors in inhaler use – Has patient technique improved over time? Chest. 2016; 150(2):394406. doi: 10.1016/j.chest.2016.03.041.Google Scholar
Castaldi, PJ, Rogers, WH, Safran, DG, Wilson, IB. Inhaler costs and medication nonadherence among seniors with chronic pulmonary disease. Chest. 2010; 138(3):614620. doi: 10.1378/chest.09-3031.Google Scholar
Tseng, C-W, Yazdany, J, Dudley, RA, et al. Medicare Part D plans’ coverage and cost-sharing for acute rescue and preventive inhalers for chronic obstructive pulmonary disease. JAMA Intern Med. 2017; 177(4):585588. doi: 10.1001/jamainternmed.2016.9386.Google Scholar
Lahousse, L, Ziere, G, Verlinden, VJ, et al. Risk of frailty in elderly with COPD: A population-based study. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2016; 71(5):689695.Google Scholar
Iyer, AS, Curtis, JR, Meier, DE. Proactive integration of geriatrics and palliative care principles into practice for chronic obstructive pulmonary disease. JAMA Intern Med. 2020; 180(6):815816. doi: 10.1001/jamainternmed.2020.1088.Google Scholar
Connors, AF, Dawson, NV, Thomas, C, et al. Outcomes following acute exacerbation of severe chronic obstructive lung disease: The SUPPORT investigators (Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments). Am J Respir Crit Care Med. 1996; 154(4 Pt 1):959967. doi: 10.1164/ajrccm.154.4.8887592.Google Scholar
Celli, BR, Cote, CG, Marin, JM, et al. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med. 2004; 350(10):10051012. doi: 10.1056/NEJMoa021322.Google Scholar
Puhan, MA, Garcia-Aymerich, J, Frey, M, et al. Expansion of the prognostic assessment of patients with chronic obstructive pulmonary disease: The updated BODE index and the ADO index. The Lancet. 2009; 374(9691):704711. doi: 10.1016/S0140-6736(09)61301-5.Google Scholar
McShane, PJ, Naureckas, ET, Tino, G, Strek, ME. Non-cystic fibrosis bronchiectasis. Am J Respir Crit Care Med. 2013; 188(6):647656. doi: 10.1164/rccm.201303-0411 CI.Google Scholar
Seitz, AE, Olivier, KN, Adjemian, J, Holland, SM, Prevots, DR. Trends in bronchiectasis among Medicare beneficiaries in the United States, 2000 to 2007. Chest. 2012; 142(2):432439. doi: 10.1378/chest.11-2209.Google Scholar
Aksamit, TR, O’Donnell, AE, Barker, A, et al. Adult patients with bronchiectasis: A first look at the US Bronchiectasis Research Registry. Chest. 2017; 151(5):982992. doi: 10.1016/j.chest.2016.10.055.Google Scholar
Polverino, E, Goeminne, PC, McDonnell, MJ, et al. European Respiratory Society guidelines for the management of adult bronchiectasis. Eur Respir J. 2017; 50(3). doi: 10.1183/13993003.00629-2017.Google Scholar
Chalmers, JD, Aliberti, S, Blasi, F. Management of bronchiectasis in adults. Eur Respir J. 2015; 45(5):14461462. doi: 10.1183/09031936.00119114.CrossRefGoogle ScholarPubMed
Daley, CL, Iaccarino, JM, Lange, C, et al. Treatment of nontuberculous mycobacterial pulmonary disease: An official ATS/ERS/ESCMID/IDSA clinical practice guideline – Executive summary. Clin Infect Dis. 2020; 71(4):e1e36. doi: 10.1093/cid/ciaa241.Google Scholar
Winthrop, KL, McNelley, E, Kendall, B, et al. Pulmonary nontuberculous mycobacterial disease prevalence and clinical features: An emerging public health disease. Am J Respir Crit Care Med. 2010; 182(7):977982. doi: 10.1164/rccm.201003-0503OC.Google Scholar
Patterson, KC, Shah, RJ, Porteous, MK, et al. Interstitial lung disease in the elderly. Chest. 2017; 151(4):838844. doi: 10.1016/j.chest.2016.11.003.Google Scholar
Raghu, G, Weycker, D, Edelsberg, J, Bradford, WZ, Oster, G. Incidence and prevalence of idiopathic pulmonary fibrosis. Am J Respir Crit Care Med. 2006; 174(7):810816. doi: 10.1164/rccm.200602-163OC.Google Scholar
Chetta, A, Marangio, E, Olivieri, D. Pulmonary function testing in interstitial lung diseases. Respiration. 2004; 71(3):209213. doi: 10.1159/000077416.Google Scholar
Bohadana, A, Izbicki, G, Kraman, SS. Fundamentals of lung auscultation. N Engl J Med. 2014; 370(8):744751. doi: 10.1056/NEJMra1302901.Google Scholar
Spicknall, KE, Zirwas, MJ, English, JC. Clubbing: an update on diagnosis, differential diagnosis, pathophysiology, and clinical relevance. J Am Acad Dermatol. 2005; 52(6):10201028. doi: 10.1016/j.jaad.2005.01.006.Google Scholar
Raghu, G, Remy-Jardin, M, Myers, JL, et al. Diagnosis of idiopathic pulmonary fibrosis: An official ATS/ERS/JRS/ALAT clinical practice guideline. Am J Respir Crit Care Med. 2018; 198(5):e44e68. doi: 10.1164/rccm.201807-1255ST.Google Scholar
Raghu, G, Collard, HR, Egan, JJ, et al. An official ATS/ERS/JRS/ALAT statement: Idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management. Am J Respir Crit Care Med. 2011; 183(6):788824. doi: 10.1164/rccm.2009-040GL.Google Scholar
King, TE, Bradford, WZ, Castro-Bernardini, S, et al. A phase 3 trial of pirfenidone in patients with idiopathic pulmonary fibrosis. New England Journal of Medicine. 2014; 370(22):20832092.CrossRefGoogle ScholarPubMed
Noble, PW, Albera, C, Bradford, WZ, et al. Pirfenidone in patients with idiopathic pulmonary fibrosis (CAPACITY): Two randomised trials. The Lancet. 2011; 377(9779):17601769. doi: 10.1016/S0140-6736(11)60405-4.Google Scholar
Richeldi, L, du Bois, RM, Raghu, G, et al. Efficacy and safety of nintedanib in idiopathic pulmonary fibrosis. New England Journal of Medicine. 2014; 370(22):20712082.Google Scholar
Meyer, KC, Danoff, SK, Lancaster, LH, Nathan, SD. Management of idiopathic pulmonary fibrosis in the elderly patient: Addressing key questions. Chest. 2015; 148(1):242252. doi: 10.1378/chest.14-2475.Google Scholar
Idiopathic Pulmonary Fibrosis Clinical Research Network, Raghu, G, Anstrom, KJ, King, TE, Lasky, JA, Martinez, FJ. Prednisone, azathioprine, and N-acetylcysteine for pulmonary fibrosis. N Engl J Med. 2012; 366(21):19681977. doi: 10.1056/NEJMoa1113354.Google Scholar
Lancaster, LH, Andrade, JA, Zibrak, JD, et al. Pirfenidone safety and adverse event management in idiopathic pulmonary fibrosis. European Respiratory Review. 2017; 26(146). doi: 10.1183/16000617.0057-2017.Google Scholar
Singer, JP, Diamond, JM, Gries, CJ, et al. Frailty phenotypes, disability, and outcomes in adult candidates for lung transplantation. American Journal of Respiratory and Critical Care Medicine. 2015; 192(11):13251334. doi: 10.1164/rccm.201506-1150OC.Google Scholar
Young, T, Palta, M, Dempsey, J, Peppard, PE, Nieto, FJ, Hla, KM. Burden of sleep apnea: Rationale, design, and major findings of the Wisconsin Sleep Cohort Study. WMJ. 2009; 108(5):246249.Google Scholar
Peppard, PE, Young, T, Barnet, JH, Palta, M, Hagen, EW, Hla, KM. Increased prevalence of sleep-disordered breathing in adults. Am J Epidemiol. 2013; 177(9):10061014. doi: 10.1093/aje/kws342.Google Scholar
Chung, F, Abdullah, HR, Liao, P. STOP-Bang questionnaire: A practical approach to screen for obstructive sleep apnea. Chest. 2016; 149(3):631638. doi: 10.1378/chest.15-0903.Google Scholar
Marin, JM, Agusti, A, Villar, I, et al. Association between treated and untreated obstructive sleep apnea and risk of hypertension. JAMA. 2012; 307(20):21692176. doi: 10.1001/jama.2012.3418.Google Scholar
Marin, JM, Carrizo, SJ, Vicente, E, Agusti, AGN. Long-term cardiovascular outcomes in men with obstructive sleep apnoea-hypopnoea with or without treatment with continuous positive airway pressure: An observational study. Lancet. 2005; 365(9464):10461053. doi: 10.1016/S0140-6736(05)71141-7.Google Scholar
Monahan, K, Storfer-Isser, A, Mehra, R, et al. Triggering of nocturnal arrhythmias by sleep-disordered breathing events. J Am Coll Cardiol. 2009; 54(19):17971804. doi: 10.1016/j.jacc.2009.06.038.Google Scholar
Kapur Vishesh, K, Auckley Dennis, H, Chowdhuri, Susmita, et al. Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: An American Academy of Sleep Medicine clinical practice guideline. Journal of Clinical Sleep Medicine. 2017; 13(3):479504. doi: 10.5664/jcsm.6506.Google Scholar
Giles, TL, Lasserson, TJ, Smith, BJ, White, J, Wright, J, Cates, CJ. Continuous positive airways pressure for obstructive sleep apnoea in adults. Cochrane Database Syst Rev. 2006; 1:CD001106. doi: 10.1002/14651858.CD001106.pub2.Google Scholar
File, TM, Marrie, TJ. Burden of community-acquired pneumonia in North American adults. Postgrad Med. 2010; 122(2):130141. doi: 10.3810/pgm.2010.03.2130.Google Scholar
Ruhnke, GW, Coca-Perraillon, M, Kitch, BT, Cutler, DM. Marked reduction in 30-day mortality among elderly patients with community-acquired pneumonia. The American Journal of Medicine. 2011; 124(2):171178.e1. doi: 10.1016/j.amjmed.2010.08.019.Google Scholar
Marrie, TJ, Huang, JQ. Epidemiology of community-acquired pneumonia in Edmonton, Alberta: An emergency department-based study. Can Respir J. 2005; 12(3):139142. doi: 10.1155/2005/672501.Google Scholar
Kalil, AC, Metersky, ML, Klompas, M, et al. Management of adults with hospital-acquired and ventilator-associated pneumonia: 2016 clinical practice guidelines by the Infectious Diseases Society of America and the American Thoracic Society. Clin Infect Dis. 2016; 63(5):e61e111. doi: 10.1093/cid/ciw353.Google Scholar
Metlay, JP, Waterer, GW, Long, AC, et al. Diagnosis and treatment of adults with community-acquired pneumonia: An official clinical practice guideline of the American Thoracic Society and Infectious Diseases Society of America. Am J Respir Crit Care Med. 2019; 200(7):e45e67. doi: 10.1164/rccm.201908-1581ST.Google Scholar
Metlay, JP, Kapoor, WN, Fine, MJ. Does this patient have community-acquired pneumonia? Diagnosing pneumonia by history and physical examination. JAMA. 1997; 278(17):14401445.Google Scholar
Lim, W, van der Eerden, MM, Laing, R, et al. Defining community acquired pneumonia severity on presentation to hospital: an international derivation and validation study. Thorax. 2003; 58(5):377382. doi: 10.1136/thorax.58.5.377.Google Scholar
Fine, MJ, Auble, TE, Yealy, DM, et al. A prediction rule to identify low-risk patients with community-acquired pneumonia. N Engl J Med. 1997; 336(4):243250. doi: 10.1056/NEJM199701233360402.Google Scholar
Givens, JL, Jones, RN, Shaffer, ML, Kiely, DK, Mitchell, SL. Survival and comfort after treatment of pneumonia in advanced dementia. Arch Intern Med. 2010; 170(13):11021107. doi: 10.1001/archinternmed.2010.181.Google Scholar
van der Steen, JT, Lane, P, Kowall, NW, Knol, DL, Volicer, L. Antibiotics and mortality in patients with lower respiratory infection and advanced dementia. J Am Med Dir Assoc. 2012; 13(2):156161. doi: 10.1016/j.jamda.2010.07.001.Google Scholar
Kröger, K, Küpper-Nybelen, J, Moerchel, C, Moysidis, T, Kienitz, C, Schubert, I. Prevalence and economic burden of pulmonary embolism in Germany. Vasc Med. 2012; 17(5):303309. doi: 10.1177/1358863X12449363.Google Scholar
Horlander, KT, Mannino, DM, Leeper, KV. Pulmonary embolism mortality in the United States, 1979–1998: An analysis using multiple-cause mortality data. Arch Intern Med. 2003; 163(14):17111717. doi: 10.1001/archinte.163.14.1711.Google Scholar
Heit, JA, O’Fallon, WM, Petterson, TM, et al. Relative impact of risk factors for deep vein thrombosis and pulmonary embolism: a population-based study. Arch Intern Med. 2002; 162(11):12451248. doi: 10.1001/archinte.162.11.1245.Google Scholar
Zöller, B, Li, X, Sundquist, J, Sundquist, K. Risk of pulmonary embolism in patients with autoimmune disorders: A nationwide follow-up study from Sweden. Lancet. 2012; 379(9812):244249. doi: 10.1016/S0140-6736(11)61306-8.Google Scholar
Goldhaber, SZ, Grodstein, F, Stampfer, MJ, et al. A prospective study of risk factors for pulmonary embolism in women. JAMA. 1997; 277(8):642645.Google Scholar
Stein, PD, Beemath, A, Matta, F, et al. Clinical characteristics of patients with acute pulmonary embolism: Data from PIOPED II. Am J Med. 2007; 120(10):871879. doi: 10.1016/j.amjmed.2007.03.024.Google Scholar
van Belle, A, Büller, HR, Huisman, MV, et al. Effectiveness of managing suspected pulmonary embolism using an algorithm combining clinical probability, D-dimer testing, and computed tomography. JAMA. 2006; 295(2):172179. doi: 10.1001/jama.295.2.172.Google ScholarPubMed
Stein, PD, Athanasoulis, C, Alavi, A, et al. Complications and validity of pulmonary angiography in acute pulmonary embolism. Circulation. 1992; 85(2):462468. doi: 10.1161/01.cir.85.2.462.Google Scholar
PIOPED Investigators. Value of the ventilation/perfusion scan in acute pulmonary embolism: Results of the prospective investigation of pulmonary embolism diagnosis (PIOPED). JAMA. 1990; 263(20):27532759. doi: 10.1001/jama.1990.03440200057023.Google Scholar
Stein, PD, Fowler, SE, Goodman, LR, et al. Multidetector computed tomography for acute pulmonary embolism. N Engl J Med. 2006; 354(22):23172327. doi: 10.1056/NEJMoa052367.Google Scholar
Kernohan, RJ, Todd, C. Heparin therapy in thromboembolic disease. Lancet. 1966; 1(7438):621623. doi: 10.1016/s0140-6736(66)90822-1.Google Scholar
Kearon, C, Akl, EA, Ornelas, J, et al. Antithrombotic therapy for VTE disease: CHEST guideline and expert panel report. Chest. 2016; 149(2):315352. doi: 10.1016/j.chest.2015.11.026.Google Scholar
Righini, M, Goehring, C, Bounameaux, H, Perrier, A. Effects of age on the performance of common diagnostic tests for pulmonary embolism. Am J Med. 2000; 109(5):357361. doi: 10.1016/s0002-9343(00)00493-9.Google Scholar
Chelluri, L, Grenvik, A, Silverman, M. Intensive care for critically ill elderly: Mortality, costs, and quality of life – Review of the literature. Arch Intern Med. 1995; 155(10):10131022. doi: 10.1001/archinte.1995.00430100033004.Google Scholar
Sprung, CL, Artigas, A, Kesecioglu, J, et al. The Eldicus prospective, observational study of triage decision making in European intensive care units. Part II: intensive care benefit for the elderly. Crit Care Med. 2012; 40(1):132138. doi: 10.1097/CCM.0b013e318232d6b0.Google Scholar
Knaus, WA, Wagner, DP, Draper, EA, et al. The APACHE III prognostic system: Risk prediction of hospital mortality for critically ill hospitalized adults. Chest. 1991; 100(6):16191636. doi: 10.1378/chest.100.6.1619.Google Scholar
Ferrante, LE, Pisani, MA, Murphy, TE, Gahbauer, EA, Leo-Summers, LS, Gill, TM. Functional trajectories among older persons before and after critical illness. JAMA Intern Med. 2015; 175(4):523529. doi: 10.1001/jamainternmed.2014.7889.Google Scholar
McNicoll, L, Pisani, MA, Zhang, Y, Ely, EW, Siegel, MD, Inouye, SK. Delirium in the intensive care unit: Occurrence and clinical course in older patients. J Am Geriatr Soc. 2003; 51(5):591598. doi: 10.1034/j.1600-0579.2003.00201.x.Google Scholar
Thomason, JW, Shintani, A, Peterson, JF, Pun, BT, Jackson, JC, Ely, EW. Intensive care unit delirium is an independent predictor of longer hospital stay: A prospective analysis of 261 non-ventilated patients. Crit Care. 2005; 9(4):R375R381. doi: 10.1186/cc3729.Google Scholar
Pisani, MA, Kong, SYJ, Kasl, SV, Murphy, TE, Araujo, KLB, Van Ness, PH. Days of delirium are associated with 1-year mortality in an older intensive care unit population. Am J Respir Crit Care Med. 2009; 180(11):10921097. doi: 10.1164/rccm.200904-0537OC.Google Scholar
Ely, EW, Margolin, R, Francis, J, et al. Evaluation of delirium in critically ill patients: Validation of the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Crit Care Med. 2001; 29(7):13701379. doi: 10.1097/00003246-200107000-00012.CrossRefGoogle ScholarPubMed
Ely, EW, Inouye, SK, Bernard, GR, et al. Delirium in mechanically ventilated patients: Validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU). JAMA. 2001; 286(21):27032710. doi: 10.1001/jama.286.21.2703.Google Scholar
Carson, SS, Kress, JP, Rodgers, JE, et al. A randomized trial of intermittent lorazepam versus propofol with daily interruption in mechanically ventilated patients. Crit Care Med. 2006; 34(5):13261332. doi: 10.1097/01.CCM.0000215513.63207.7F.Google Scholar
Girard, TD, Exline, MC, Carson, SS, et al. Haloperidol and ziprasidone for treatment of delirium in critical illness. N Engl J Med. 2018; 379(26):25062516. doi: 10.1056/NEJMoa1808217.Google Scholar
Ferrante, LE, Murphy, TE, Gahbauer, EA, Leo-Summers, LS, Pisani, MA, Gill, TM. Pre–intensive care unit cognitive status, subsequent disability, and new nursing home admission among critically ill older adults. Ann Am Thorac Soc. 2018; 15(5):622629. doi: 10.1513/AnnalsATS.201709-702OC.Google Scholar
Brummel, NE, Balas, MC, Morandi, A, Ferrante, LE, Gill, TM, Ely, EW. Understanding and reducing disability in older adults following critical illness. Crit Care Med. 2015; 43(6):12651275. doi: 10.1097/CCM.0000000000000924.Google Scholar
Angus, DC, Linde-Zwirble, WT, Lidicker, J, Clermont, G, Carcillo, J, Pinsky, MR. Epidemiology of severe sepsis in the United States: Analysis of incidence, outcome, and associated costs of care. Crit Care Med. 2001; 29(7):13031310. doi: 10.1097/00003246-200107000-00002.Google Scholar
Carson, SS. Outcomes of prolonged mechanical ventilation. Curr Opin Crit Care. 2006; 12(5):405411. doi: 10.1097/01.ccx.0000244118.08753.dc.Google Scholar
Weng, C-L, Zhao, Y-T, Liu, Q-H, et al. Meta-analysis: Noninvasive ventilation in acute cardiogenic pulmonary edema. Ann Intern Med. 2010; 152(9):590600. doi: 10.7326/0003-4819-152-9-201005040-00009.Google Scholar
Somogyi-Zalud, E, Zhong, Z, Hamel, MB, Lynn, J. The use of life-sustaining treatments in hospitalized persons aged 80 and older. J Am Geriatr Soc. 2002; 50(5):930934. doi: 10.1046/j.1532-5415.2002.50222.x.Google Scholar
Lynn, J, Goldstein, NE. Advance care planning for fatal chronic illness: Avoiding commonplace errors and unwarranted suffering. Ann Intern Med. 2003; 138(10):812818. doi: 10.7326/0003-4819-138-10-200305200-00009.CrossRefGoogle ScholarPubMed

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