Factors associated with death among adults <55 years of age hospitalized for community-acquired pneumonia
Factors associated with death among adults <55 years of age hospitalized for community-acquired pneumonia
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DOI：
10.1086/346037
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发表时间：
2003-02-15
影响因子：
11.8
通讯作者：
Johnson, DH
中科院分区：
文献类型：
--
作者：
Marrie, TJ;Carriere, KC;Johnson, DH
使用一个行政数据库来研究1994年4月1日至1999年3月31日期间因社区获得性肺炎住院治疗的18-55岁成年人的死亡情况。 11,684 名住院患者的住院前 10 天和总体病死率分别为 2.1% 和 3.2%。患者因素（年龄、性别和合并症）是与死亡最重要的关联。误吸是住院前 10 天死亡差异的最大解释（比值比，5.0；95% 置信区间，3.7-6.8）。繁忙的医院（入住率较高和每日入院人数较多）与较高的病死率无关。较大的医院（大城市医院）的病死率较高，但这更有可能与肺炎的合并症和严重程度较高有关。在青壮年中，社区获得性肺炎导致的死亡并不常见，而且与肺炎的严重程度和误吸等危险因素的关系更大，而不是与提供护理的方式有关。
An administrative database was used to study death occurring among adults aged 18-55 years who were hospitalized during the period from 1 April 1994 through 31 March 1999 for treatment of community-acquired pneumonia. In-hospital case-fatality rates for the first 10 days of hospitalization and overall were 2.1% and 3.2%, respectively, for 11,684 patient hospitalizations. Patient factors (age, sex, and comorbidity) were the most important associations with death. Aspiration provided the largest explanation of variance in deaths occurring during the first 10 days of hospitalization (odds ratio, 5.0; 95% confidence interval, 3.7-6.8). Busy hospitals (higher occupancy and higher number of daily admissions) were not associated with higher case-fatality rates. Bigger hospitals (metropolitan hospitals) had higher case-fatality rates, but this was more likely related to greater comorbidity and severity of pneumonia. Death due to community- acquired pneumonia among young and middle-aged adults is infrequent and is more related to the severity of pneumonia and to such risk factors as aspiration than to the manner in which the provision of care is organized.