Long-term care level as a predictor of a poor outcome in elderly patients with pneumonia
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- Miyagishima Kei
- Department of Geriatric Medicine, Kyorin University School of Medicine
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- Matsui Toshifumi
- Department of Geriatric Medicine, Kyorin University School of Medicine
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- Obara Toshimasa
- Department of Geriatric Medicine, Kyorin University School of Medicine
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- Mitsuma Sayuri
- Department of Geriatric Medicine, Kyorin University School of Medicine
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- Tanaka Masamichi
- Department of Geriatric Medicine, Kyorin University School of Medicine
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- Wachi Yoshitaka
- Department of Geriatric Medicine, Kyorin University School of Medicine
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- Kobayashi Yoshio
- Department of Geriatric Medicine, Kyorin University School of Medicine
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- Hasegawa Hiroshi
- Department of Geriatric Medicine, Kyorin University School of Medicine
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- Kozaki Koichi
- Department of Geriatric Medicine, Kyorin University School of Medicine
Bibliographic Information
- Other Title
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- 高齢者肺炎入院患者における予後規定因子の検討―入院治療による介護度の変化を中心に―
- コウレイシャ ハイエン ニュウイン カンジャ ニ オケル ヨゴ キテイ インシ ノ ケントウ : ニュウイン チリョウ ニ ヨル カイゴド ノ ヘンカ オ チュウシン ニ
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Abstract
Aim: To determine factors associated with physical decline and a poor prognosis after hospitalization in physically dependent elderly patients with acute pneumonia. Methods: The subjects included 112 geriatric patients (86.8±5.5 years old) with acute pneumonia consecutively admitted to an inpatient unit of Geriatric Medicine, Kyorin University Hospital in the period from April 2012 to March 2013. All patients were generally treated with broad-spectrum antibiotics according to nursing- and healthcare-associated pneumonia (NHCAP) guidelines. The patients' baseline severity of pneumonia was evaluated according to the A-Drop score and their physical dependency was assessed according to the JABC score before and after admission. Results: The patients were categorized into the community acquired pneumonia group (CAP) (n=29) and NHCAP group (n=83). The patients in the NHCAP group had a longer hospital stay (NHCAP vs. CAP: 33 vs. 21 days, p=0.02), higher A-Drop scores (2.88±0.80 vs. 2.45±0.87 points, p=0.02) and were more frequently diagnosed with aspiration pneumonia (89.2% vs. 42.9%, p<0.0001) than those in the CAP group. Three patients in the CAP group (10.3%) and 13 patients in the NHCAP group (15.7%) died during their hospital stay (p=0.69). Although the rest of the patients were successfully treated for pneumonia, their physical dependency progressed after admission in both groups (p<0.0001). After adjusting for age, gender and the JABC score before admission, NHCAP (risk ratio against CAP: 6.2, 95% CI 1.2-32.2, p=0.03) and a serum albumin lower than 2.5 g/dl (RR: 7.8, 95%CI 1.7-35.7, p<0.01) were significantly associated with the progression of physical dependency after admission. Conclusions: The diagnosis of NHCAP is a risk factor for the progression of physical dependency. Therefore, palliative care may be an optional approach for frail patients.
Journal
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- Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics
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Nippon Ronen Igakkai Zasshi. Japanese Journal of Geriatrics 52 (3), 260-268, 2015
The Japan Geriatrics Society
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Keywords
Details 詳細情報について
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- CRID
- 1390001205023586048
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- NII Article ID
- 130005093067
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- NII Book ID
- AN00199010
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- NDL BIB ID
- 026651840
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- ISSN
- 03009173
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- PubMed
- 26268384
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- Text Lang
- ja
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- Data Source
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- JaLC
- NDL
- Crossref
- PubMed
- CiNii Articles
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- Abstract License Flag
- Disallowed