Factor Analysis of Prolonged Hospital Stay of Elderly Patients with Community-Acquired Pneumonia

为分析60岁以上老年社区获得性肺炎(CAP)患者住院时间延长的影响因素，对K门诊19个床位的老年肺炎患者的年龄、基础疾病、入院时的活动能力、肺炎的严重程度、检查和治疗、住院时间进行了调查。K诊所的肺炎检测和治疗遵循标准化指南。在30名接受调查的老年CAP患者中，20名没有潜在疾病(A组)。这些患者的平均住院时间约为10天(平均年龄为72.8岁)。根据胸部X线片和体格检查结果评估肺炎的严重程度，A组中17例为轻度，其余3例为中度。在30例接受检查的患者中，有10例有一些慢性基础疾病，这些患者被归入B组。该组患者的平均住院时间为17天，平均年龄为71.2岁。本组所有患者的肺炎严重程度均为轻度。评估入院时的活动能力，A、B两组患者均可独立行走。A组的平均住院时间明显短于B组，表明老年CAP患者的住院时间延长与基础慢性病的存在有关。这与Fine等人(1993)的观察一致。

To analyze the factors involved in prolonged hospital stay of elderly patients (over 60 Years old) with community acquired pneumonia (CAP), the elderly patients with pneumonia managed at K Clinic (a 19-bed clinic) were investigated as to : (1) the age, (2) underlying disease, (3) mobility at the time of admission, (4) severity of pneumonia, (5) tests and treatment, and (6) length of hospital stay. The tests and treatment for pneumonia at the K Clinic follow standardized guidelines. The patient is discharged when the clinical signs of inflammation and the radioopacity on the chest radiograph have resolved.Of the 30 elderly patients with CAP who were thus investigated, 20 had no underlying disease (Group A). The mean length of hospital stay for these patients was about 10 days(the mean age was 72.8 years). The severity of pneumonia, as evaluated based on the extent of radioopacity on the chest radiograph and the physical findings, was rated as mild in 17 patients and moderate in the remaining 3 patients from Group A. Ten of the total of 30 patients examined had some chronic underlying disease, and these patients were assigned to Group B. The mean length of hospital stay in this group was 17 days, and the mean age was 71.2 years. The severity of pneumonia was rated as mild in all the patients of this group. When mobility at the time of admission was evaluated, all the patients from both Groups A and B could walk unassisted. The finding that the mean length of hospital stay was significantly shorter in Group A than in Group B indicates that prolonged hospital stay of elderly patients with CAP is associated with the presence of underlying chronic disease. This is consistent with the observation of Fine et al.(1993).