Healthcare-Associated Pneumonia among Hospitalized Patients: Is It Different from Community Acquired Pneumonia? / 결핵및호흡기질환
Tuberculosis and Respiratory Diseases
;
: 66-74, 2014.
Artigo
em Inglês
| WPRIM
| ID: wpr-164110
ABSTRACT
BACKGROUND:
The increasing number of outpatients with multidrug-resistant (MDR) pathogens has led to a new category of pneumonia, termed healthcare-associated pneumonia (HCAP). We determined the differences in etiology and outcomes between patients with HCAP and those with community-acquired pneumonia (CAP) to clarify the risk factors for HCAP mortality.METHODS:
A retrospective study comparing patients with HCAP and CAP at Jeju National University Hospital. The primary outcome was 30-day mortality.RESULTS:
A total of 483 patients (208 patients HCAP, 275 patients with CAP) were evaluated. Patients with HCAP were older than those with CAP (median, 74 years; interquartile range [IQR], 65-81 vs. median, 69 years; IQR, 52-78; p<0.0001). Streptococcus pneumoniae was the major pathogen in both groups, and MDR pathogens were isolated more frequently from patients with HCAP than with CAP (18.8% vs. 4.9%, p<0.0001). Initial pneumonia severity was greater in patients with HCAP than with CAP. The total 30-day mortality rate was 9.9% and was higher in patients with HCAP based on univariate analysis (16.3% vs. 5.1%; odds ratio (OR), 3.64; 95% confidence interval (CI), 1.90-6.99; p<0.0001). After adjusting for age, sex, comorbidities, and initial severity, the association between HCAP and 30-day mortality became non-significant (OR, 1.98; 95% CI, 0.94-4.18; p=0.167).CONCLUSION:
HCAP was a common cause of hospital admissions and was associated with a high mortality rate. This increased mortality was related primarily to age and initial clinical vital signs, rather than combination antibiotic therapy or type of pneumonia.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Pacientes Ambulatoriais
/
Pneumonia
/
Streptococcus pneumoniae
/
Resistência a Medicamentos
/
Comorbidade
/
Razão de Chances
/
Estudos Retrospectivos
/
Fatores de Risco
/
Mortalidade
/
Sinais Vitais
Tipo de estudo:
Estudo de etiologia
/
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Humanos
Idioma:
Inglês
Revista:
Tuberculosis and Respiratory Diseases
Ano de publicação:
2014
Tipo de documento:
Artigo
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