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A retrospective study of refractory pneumonia (n = 54), who were randomly selected from total of 657 cases of pneumonia in the elderly, was performed. These were divided into the following two groups in terms of complications. The group with multiple organ failure (MOF group; n = 30), complicated by multiple organ failure during their clinical course of refractory pneumonia, was compared with refractory pneumonia without multiple organ failure (non-MOF group; n = 24). Among 57% of cases of the MOF group, respiratory failure developed prior to MOF and among 37% of the cases respiratory failure occurred simultaneously with MOF. The respiratory failure in the MOF group was closely related to coagulopathy. Histopathological studies of the MOF group revealed remarkable congestion and edema. From these observations, respiratory management is considered the most important to avoid concomitant multiple organ failure.

A study of refractory pneumonia complicated by multiple organ failure in the elderly.