The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Facility characteristics as independent prognostic factors of nursing home-acquired pneumonia

  • Lim, Che Wan (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Myongji Hospital, Seonam University College of Medicine) ;
  • Choi, Younghoon (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Myongji Hospital, Seonam University College of Medicine) ;
  • An, Chang Hyeok (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Myongji Hospital, Seonam University College of Medicine) ;
  • Park, Sang Joon (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Myongji Hospital, Seonam University College of Medicine) ;
  • Hwang, Hee-Jin (Geriatric Center, Department of Family Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine) ;
  • Chung, Jae Ho (Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine) ;
  • Min, Joo-Won (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Myongji Hospital, Seonam University College of Medicine)
  • Received : 2014.08.22
  • Accepted : 2015.12.17
  • Published : 2016.03.01
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Abstract

Background/Aims: Recently, the incidence of nursing home-acquired pneumonia (NHAP) has been increasing and is now the leading cause of death among nursing home residents. This study was performed to identify risk factors associated with NHAP mortality, focusing on facility characteristics. Methods: Data on all patients ${\geq}70years$ of age admitted with newly diagnosed pneumonia were reviewed. To compare the quality of care in nursing facilities, the following three groups were defined: patients who acquired pneumonia in the community, care homes, and care hospitals. In these patients, 90-day mortality was compared. Results: Survival analyses were performed in 282 patients with pneumonia. In the analyses, 90-day mortality was higher in patients in care homes (12.2%, 40.3%, and 19.6% in community, care homes, and care hospitals, respectively). Among the 118 NHAP patients, residence in a care home, structural lung diseases, treatment with inappropriate antimicrobial agents for accompanying infections, and a high pneumonia severity index score were risk factors associated with higher 90-day mortality. However, infection by potentially drug-resistant pathogens was not important. Conclusions: Unfavorable institutional factors in care homes are important prognostic factors for NHAP.

Keywords

References

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