Clinical characteristics of healthcare-associated pneumonia in a public hospital in a metropolitan area of Japan

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• 作者：Midori Sugisaki (1) mgrmidori@hotmail.com
  Tatsuji Enomoto (1) enomoto@nms.ac.jp
  Yasuhiro Shibuya (2) shibuyay@jichi.ac.jp
  Aki Matsumoto (1)
  Hitoshi Saitoh (1) sahi@nms.ac.jp
  Akiko Shingu (1)
  Ritsuko Narato (1)
  Koichiro Nomura (1) knomura@hiroo-hospital.metro.tokyo.jp
• 关键词：Pneumonia – ; Healthcare associated – ; Severity – ; Mortality – ; Nutrition
• 刊名：Journal of Infection and Chemotherapy
• 出版年：2012
• 出版时间：June 2012
• 年：2012
• 卷：18
• 期：3
• 页码：352-360
• 全文大小：201.1 KB
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• 作者单位：1. Department of Respiratory Medicine, Tokyo Metropolitan Hiroo General Hospital, 2-34-10 Ebisu, Shibuya-ku, Tokyo, 150-0013 Japan2. Department of Infectious Diseases, Tokyo Metropolitan Hiroo General Hospital, Tokyo, Japan
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Infectious Diseases
  Oncology
  Internal Medicine
  
• 出版者：Springer Japan
• ISSN：1437-7780

文摘

Healthcare-associated pneumonia (HCAP) is a new category that is essential in the present aging society. Knowing the different characteristics and outcomes between patients with HCAP and community-acquired pneumonia (CAP) would help physicians manage and treat HCAP patients. Although HCAP is thought to be heterogeneous in regions, there are no reports from a metropolitan area in Japan. We retrospectively reviewed the clinical findings of all consecutive pneumonia patients who required hospitalized care in our hospital between April 2006 and March 2010. There were 184 (35.0%) patients with HCAP and 342 (65.0%) patients with CAP. Previous hospitalization within 90 days of the infection was the most common criterion for HCAP (63.0%). HCAP patients were significantly older than CAP patients (82.5 vs. 70.0 years, P < 0.001). The percentage of patients with poor functional status was higher in HCAP than CAP (64.0% vs. 26.6%, P < 0.001). Hospital mortality was significantly higher in HCAP patients than in CAP patients (15.8% vs. 5.0%, P < 0.001). Low levels of serum albumin (odds ratio, 0.126; 95% CI, 0.025–0.640; P = 0.012) and high scores in the ADROP (age, dehydration, respiratory failure, orientation, and blood pressure) system (odds ratio, 2.846; 95% CI, 1.449–5.587; P = 0.002) were the risk factors for HCAP mortality. In conclusion, patients with HCAP have different epidemiological characteristics compared with those with CAP in a metropolitan area of Japan. Outcomes and risk factors for mortality of patients with HCAP included poor nutritional status and high severity scores on the pneumonia severity scoring system.