Abstract
Of 180 autopsies at Nagoya-shi Koseiin Geriatric Hospital during the period from January 1979 to February 1982, pneumonia was found in 102 (57%) of cases. It was the most frequent cause of death (53 cases). In order to investigate this fatal infection, a clinicopathological study of pneumonia in the elderly was conducted.
Cerebral vascular disease and heart disease were the most frequent underlying diseases. There was a positive correlation between the death rate caused by pneumonia and the extent of the pneumonic process as determined by the number of lobes involved at autopsy. Focal pneumonia was the most frequent pathological type of pneumonia, and was found in 87% of the cases. Hypostatic and aspiration pneumonia were found in some of these cases. There were only seven cases of lobar pneumonia. Cases of lobar pneumonia, aspiration pneumonia and pulmonary suppuration have a greater likelihood of the cause of death being recorded as pneumonia. According to the classification of pathologic features of the pneumonia based upon the distribution of lesions, alveolar pneumonia was found in 70% of the cases, followed by mixed interstitial-alveolar pneumonia (10%), and others (20%). Congestion and/or edema were found in 49% of the cases suggesting that these might play an important role in the pathogenesis of pneumonia.
