Outcomes in elderly Danish citizens admitted with community-acquired pneumonia. Regional differencties, in a public healthcare system
Outcomes in elderly Danish citizens admitted with community-acquired pneumonia. Regional differencties, in a public healthcare system
复制标题
DOI：
10.1016/j.rmed.2012.08.010
复制
发表时间：
2012-12-01
影响因子：
4.3
通讯作者：
Andersen, O.
中科院分区：
文献类型：
--
作者：
Klausen, H. H.;Petersen, J.;Andersen, O.
目的：为了评估区域差异和危险因素的入院，住院时间，死亡率和再入院的社区获得性肺炎在老年Danish patients.Methods：国家登记研究老年丹麦公民在2009年急性入院，由于社区获得性肺炎。我们研究了住院时间，住院死亡率，出院后30天内死亡率，出院后30天内再入院的医院之间的差异，使用考克斯回归模型，调整年龄，性别，辅助治疗，并通过Charlson指数score.Results合并症：共11，332老年公民社区获得性肺炎入院。住院期间和出院后30天的死亡率分别为11.6%和16.2%。出院后30天内再入院率为12.3%。住院时间在医院间有显著差异。高Charlson指数评分和高龄是住院期间和出院后30天内死亡的显著危险因素。男性和高Charlson指数评分是再入院的重要危险因素。大床位容量的医院入院是一个显着的危险因素，死亡和再入院30 days内discharge.Conclusions：住院时间，入院率，死亡率和再入院老年丹麦社区获得性肺炎患者如下国际调查结果。医院之间存在地区差异。在epth研究中，区域差异可以揭示潜在的可行的临床干预措施，改善再入院率，死亡率和成本。(C)2012爱思唯尔有限公司保留所有权利。
Objectives: To evaluate regional differences in and risk factors for admission, length of stay, mortality, and readmission for community-acquired pneumonia in elderly Danish patients.Methods: National registry study on elderly Danish citizens with an acute admission in 2009 owing to community-acquired pneumonia. We studied differences among hospitals in length of stay, in-hospital mortality, mortality within 30 days of discharge, and readmission within 30 days after discharge using Cox regression models with adjustments for age, sex, ventilatory support, and co-morbidity by Charlson's index score.Results: A total of 11,332 elderly citizens were admitted with community-acquired pneumonia. Mortality during admission and 30-days from discharge were 11.6% and 16.2%, respectively. Readmission rates within 30 days of discharge were 12.3%. There were significantly differences between hospitals in length of stay. A high Charlson index score and advanced age were significantly risk factors for death during admission and within 30 days of discharge. Male sex and high Charlson index score were significant risk factors for readmission. Admission to large bed capacity hospital was a significant risk factor for death and readmission within 30 days of discharge.Conclusions: Length of stay, rate of admission, mortality and readmission in elderly Danish patients with community-acquired pneumonia follows international findings. There are regional differences between hospitals. In epth investigation in regional differences could reveal potential feasible clinical interventions with an improvement of readmission-, mortality rates and cost. (C) 2012 Elsevier Ltd. All rights reserved.