Abstract
BACKGROUND: Nursing home-acquired pneumonia (NHAP) is the leading cause of death among long-term care patients and the second most common cause of transfers to acute care facilities.
AIMS: The objective was to characterize the incidences, microbiology, and outcomes for hospitalized patients with community-acquired pneumonia (CAP) and NHAP.
METHODS: A secondary analysis of 5,160 patients from the Community-Acquired Pneumonia Organization (CAPO) database was performed. World regions were defined as North America (I), Latin America (II) and Europe (III).
RESULTS: From a total of 5,160 hospitalized patients with CAP, NHAP was identified in 287 (5.6%) patients. Mean age was 80 years old. NHAP distribution by region was 7% in region I, 3% in region II, 7% in region III. NHAP had more frequently neurological disease, D.M., congestive heart failure, renal failure than CAP patients (p<0,001). ICU admission was required in 32 (11%) patients. Etiology was defined in 68 (24%) patients with NHAP and 1,300 (27%) with CAP. The most common pathogens identified in NHAP included Streptococcus pneumoniae (31%), Staphylococcus spp (31%) and Pseudomonas aeruginosa (12%). The presentation of NHAP included more often pleural effusions (28% vs. 19%, p<0.001) and multilobar involvement (31% vs. 24%, p<0.001). The 30-day hospital mortality was statistically greater among patients with NHAP than among those with CAP (42% versus 18%; p<0.001).
CONCLUSIONS: Worldwide, only a very small proportion of hospitalized CAP patients present with NHAP, whose poor outcomes may be primarily due to a higher number of comorbidities comparing to patients without NHAP.
Footnotes
- Corresponding author:
Liapikou Adamantia, 3rd Respiratory Department Sotiria Chest Diseases Hospital, Mesogion 152, 11527, Athens, fax number: 00302109950614 Email: mliapikou{at}yahoo.com
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