Tuberculosis and Respiratory Diseases

  • 제76권2호
  • /
  • Pages.66-74
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  • 2014
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  • 1738-3536(pISSN)
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  • 2005-6184(eISSN)
대한결핵및호흡기학회 (The Korean Academy of Tuberculosis and Respiratory Diseases)
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Healthcare-Associated Pneumonia among Hospitalized Patients: Is It Different from Community Acquired Pneumonia?

  • Seong, Gil Myung (Department of Internal Medicine, Jeju National University School of Medicine) ;
  • Kim, Miok (Department of Internal Medicine, Jeju National University School of Medicine) ;
  • Lee, Jaechun (Department of Internal Medicine, Jeju National University School of Medicine) ;
  • Lee, Jong Hoo (Department of Internal Medicine, Jeju National University School of Medicine) ;
  • Jeong, Sun Young (Department of Radiology, Jeju National University School of Medicine) ;
  • Choi, Yunsuk (Department of Anesthesia and Pain Medicine, Jeju National University School of Medicine) ;
  • Kim, Woo Jeong (Department of Emergency Medicine, Jeju National University School of Medicine)
  • 투고 : 2012.11.20
  • 심사 : 2014.01.29
  • 발행 : 2014.02.28
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초록

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.

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피인용 문헌

  1. Disease characteristics and management of hospitalised adolescents and adults with community-acquired pneumonia in China: a retrospective multicentre survey vol.8, pp.2, 2014, https://doi.org/10.1136/bmjopen-2017-018709