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Background <p>Pneumonia remains a leading cause of morbidity and mortality worldwide, particularly among older adults, who are more vulnerable to severe clinical outcomes due to age-related physiological changes and comorbidities. However, in resource-limited settings, data on determinants of pneumonia severity in aging populations remain scarce. This study aimed to identify clinical factors associated with severe pneumonia among adults hospitalized in a tertiary care hospital in the Democratic Republic of the Congo, with particular attention to the role of age and functional status.</p> Methods <p>We conducted a retrospective cross-sectional study from January 2022 to September 2024 in the Pulmonology Unit of the University Hospital of Kinshasa. All adult patients (≥ 18 years) with radiologically confirmed pneumonia were included. Demographic, clinical, biological, and treatment data were extracted from medical records. Severe pneumonia was defined as the presence of at least three minor severity criteria based on adapted international guidelines. Bivariate analyses were performed using chi-square or Fisher’s exact tests. A multivariable logistic regression model was used to identify independent predictors of severity, with adjusted odds ratios (aORs) and 95% confidence intervals (95% CI).</p> Results <p>A total of 95 patients were included, with a mean age of 56.3 years, and 35.8% aged 65 years or older. Older patients more frequently presented with indicators of severity at admission, including hypoxemia, confusion, and increased use of oxygen therapy. In bivariate analysis, age ≥ 65 years was significantly associated with severe pneumonia (<i>p</i> = 0.0268). However, in multivariable analysis, physical asthenia emerged as the only independent predictor of severity (aOR = 3.30; 95% CI: 1.13–9.65; <i>p</i> = 0.029), whereas age ≥ 65 years (aOR = 2.48; 95% CI: 0.85–7.21; <i>p</i> = 0.093) and elevated C-reactive protein levels (aOR = 1.78; 95% CI: 0.64–4.89; <i>p</i> = 0.263) were not independently associated with severity.</p> Conclusion <p>Although older adults more frequently presented with clinical indicators of severity, age was not an independent predictor of severe pneumonia after adjustment for clinical and biological variables. Physical asthenia, reflecting functional decline and reduced physiological reserve, emerged as a key determinant of severity in this population. These findings highlight the importance of incorporating functional status assessment into clinical evaluation and risk stratification of pneumonia, particularly in resource-limited settings where simple clinical indicators may support early identification of high-risk patients.</p>

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Targeted interventions for pneumonia in older adults: challenges and opportunities in Sub-Saharan Africa

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月23日

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  • Mélanie Kinzunga Ngutuka,
  • Daniel Masisa Matondo,
  • Dieudonné Mukendi Mpunga,
  • Serge Fweza Bisuta,
  • Guillaume Mbela Kiyombo,
  • Elisephane Irankunda,
  • Benoit Obel Kabengele,
  • Jean Marie Ntumba Kayembe

摘要

Background

Pneumonia remains a leading cause of morbidity and mortality worldwide, particularly among older adults, who are more vulnerable to severe clinical outcomes due to age-related physiological changes and comorbidities. However, in resource-limited settings, data on determinants of pneumonia severity in aging populations remain scarce. This study aimed to identify clinical factors associated with severe pneumonia among adults hospitalized in a tertiary care hospital in the Democratic Republic of the Congo, with particular attention to the role of age and functional status.

Methods

We conducted a retrospective cross-sectional study from January 2022 to September 2024 in the Pulmonology Unit of the University Hospital of Kinshasa. All adult patients (≥ 18 years) with radiologically confirmed pneumonia were included. Demographic, clinical, biological, and treatment data were extracted from medical records. Severe pneumonia was defined as the presence of at least three minor severity criteria based on adapted international guidelines. Bivariate analyses were performed using chi-square or Fisher’s exact tests. A multivariable logistic regression model was used to identify independent predictors of severity, with adjusted odds ratios (aORs) and 95% confidence intervals (95% CI).

Results

A total of 95 patients were included, with a mean age of 56.3 years, and 35.8% aged 65 years or older. Older patients more frequently presented with indicators of severity at admission, including hypoxemia, confusion, and increased use of oxygen therapy. In bivariate analysis, age ≥ 65 years was significantly associated with severe pneumonia (p = 0.0268). However, in multivariable analysis, physical asthenia emerged as the only independent predictor of severity (aOR = 3.30; 95% CI: 1.13–9.65; p = 0.029), whereas age ≥ 65 years (aOR = 2.48; 95% CI: 0.85–7.21; p = 0.093) and elevated C-reactive protein levels (aOR = 1.78; 95% CI: 0.64–4.89; p = 0.263) were not independently associated with severity.

Conclusion

Although older adults more frequently presented with clinical indicators of severity, age was not an independent predictor of severe pneumonia after adjustment for clinical and biological variables. Physical asthenia, reflecting functional decline and reduced physiological reserve, emerged as a key determinant of severity in this population. These findings highlight the importance of incorporating functional status assessment into clinical evaluation and risk stratification of pneumonia, particularly in resource-limited settings where simple clinical indicators may support early identification of high-risk patients.