Outcomes of Patients with Healthcare-Associated Pneumonia: Worse Disease or Sicker Patients?
Outcomes of Patients with Healthcare-Associated Pneumonia: Worse Disease or Sicker Patients?
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DOI：
10.1086/677829
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发表时间：
2014-10-01
影响因子：
4.5
通讯作者：
Zilberberg, Marya D.
中科院分区：
文献类型：
--
作者：
Rothberg, Michael B.;Haessler, Sarah;Zilberberg, Marya D.
BACKGROUND. Healthcare-associated pneumonia (HCAP) is an entity distinct from community-acquired pneumonia (CAP). HCAP has a higher case-fatality rate, due either to HCAP organisms or to the health status of HCAP patients. The contribution of HCAP criteria to case-fatality rate is unknown.METHODS. We conducted a retrospective review of adult patients admitted with a diagnosis of pneumonia from July 2007 through November 2011 to 491 US hospitals. HCAP was defined as having at least 1 of the following: prior hospitalization within 90 days, hemodialysis, admission from a skilled nursing facility, or immune suppression. We compared characteristics of patients with CAP and patients with HCAP and explored the contribution of HCAP criteria to case-fatality rate in a hierarchical generalized linear model.RESULTS. Of 436,483 patients hospitalized with pneumonia, 149,963 (34.4%) had HCAP. Compared to CAP patients, HCAP patients were older, had more comorbidities, and were more likely to require intensive care unit (ICU) care. In-hospital case-fatality rate was higher among patients with HCAP, compared to those with CAP (11.1% vs 5.1%, P
