TY - JOUR T1 - A Worldwide Perspective of Nursing Home-Acquired Pneumonia compared to Community-acquired Pneumonia JF - Respiratory Care DO - 10.4187/respcare.02788 SP - respcare.02788 AU - A Liapikou AU - E Polverino AU - C Cilloniz AU - P Peyrani AU - J Ramirez AU - R Menendez AU - A Torres AU - the Community-Acquired Pneumonia Organization (CAPO) Investigators Y1 - 2013/11/05 UR - http://rc.rcjournal.com/content/early/2013/11/05/respcare.02788.abstract N2 - 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. ER -