@article {Liapikourespcare.02788, author = {A Liapikou and E Polverino and C Cilloniz and P Peyrani and J Ramirez and R Menendez and A Torres and the Community-Acquired Pneumonia Organization (CAPO) Investigators}, title = {A Worldwide Perspective of Nursing Home-Acquired Pneumonia compared to Community-acquired Pneumonia}, elocation-id = {respcare.02788}, year = {2013}, doi = {10.4187/respcare.02788}, publisher = {Respiratory Care}, 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.}, issn = {0020-1324}, URL = {https://rc.rcjournal.com/content/early/2013/11/05/respcare.02788}, eprint = {https://rc.rcjournal.com/content/early/2013/11/05/respcare.02788.full.pdf}, journal = {Respiratory Care} }