Clinical characteristics of nursing home-acquired pneumonia in elderly patients admitted to a Korean teaching hospital
The Korean Journal of Internal Medicine
;
: 638-647, 2015.
Artigo
em Inglês
| WPRIM
| ID: wpr-216627
ABSTRACT
BACKGROUND/AIMS:
Nursing home-acquired pneumonia (NHAP) is included under healthcare-associated pneumonia. However, the optimal treatment strategy for NHAP has been controversial in several studies. We evaluated the clinical features of NHAP compared to community-acquired pneumonia (CAP) in elderly patients admitted with pneumonia.METHODS:
This was a retrospective study in elderly patients aged > or = 65 years with NHAP or CAP who were hospitalized at Jeju National University Hospital between January 2012 and April 2013.RESULTS:
A total of 209 patients were enrolled, and 58 (27.7%) had NHAP. The patients with NHAP were older, had more frequent central nervous system disorders, and showed worse clinical parameters. Potential drug-resistant pathogens were more frequently detected in the NHAP group (22.4% vs. 9.9%, p = 0.018), and the incidences of Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus were 8.6% and 10.3%, respectively. In-hospital mortality occurred in 13 patients (22.4%) with NHAP and 17 patients (11.2%) with CAP (p = 0.039). In multivariate analyses, only higher pneumonia severity index (PSI) score was associated with increased mortality (p < 0.001), and the PSI score was higher in the NHAP group than that in the CAP group.CONCLUSIONS:
Elderly patients admitted with NHAP showed more severe pneumonia at onset, higher rates of potentially drug-resistant pathogens, and worse clinical outcomes than those with CAP. However, higher in-hospital mortality in those with NHAP seemed to be related to the PSI score reflecting host factors and severity of pneumonia rather than the type of pneumonia or the presence of drug-resistant pathogens.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Admissão do Paciente
/
Índice de Gravidade de Doença
/
Testes de Sensibilidade Microbiana
/
Distribuição de Qui-Quadrado
/
Modelos Logísticos
/
Razão de Chances
/
Infecção Hospitalar
/
Análise Multivariada
/
Estudos Retrospectivos
/
Fatores de Risco
Tipo de estudo:
Estudo de etiologia
/
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Idoso
/
Aged80
/
Feminino
/
Humanos
/
Masculino
País/Região como assunto:
Ásia
Idioma:
Inglês
Revista:
The Korean Journal of Internal Medicine
Ano de publicação:
2015
Tipo de documento:
Artigo
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