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Clinical characteristics and outcomes among older nursing home residents hospitalized with pneumonia

Authors
 Nam Eun Kim  ;  Jin Hwa Lee  ;  Jung Hyun Chang  ;  Su Hwan Lee  ;  Yon Ju Ryu 
Citation
 ARCHIVES OF GERONTOLOGY AND GERIATRICS, Vol.95 : 104394, 2021-03 
Journal Title
 ARCHIVES OF GERONTOLOGY AND GERIATRICS 
ISSN
 0167-4943 
Issue Date
2021-03
Keywords
Antimicrobial resistance ; Community-acquired pneumonia ; Nursing homes ; Older adults
Abstract
Background: Due to population aging, the number of cases of pneumonia in nursing homes in South Korea has been increasing. This study investigated the characteristics and clinical outcomes in nursing home residents with pneumonia admitted to a tertiary hospital. Methods: A retrospective cohort study was conducted of patients transferred to the tertiary hospital from nursing homes between August 2009 and October 2016. The in-hospital mortality, Pneumonia Severity Index, bacterial pathogens in sputum cultures, and antibiotic sensitivity profile were assessed. Results: The analysis included a total of 174 patients hospitalized with pneumonia. Their median age was 78 years, and 109 patients (62.6%) were male. 108 patients (62.1%) were admitted to the intensive care unit. The in-hospital mortality rate was 12.6% (22/174). Culture of a multidrug-resistant (MDR) pathogen was an independent risk factor for mortality (odds ratio [OR]: 3.72, 95% confidence interval [CI]: 1.16-11.89). Male sex and a history of antibiotic use within the previous 3 months were independent risk factors for MDR pathogen isolation (OR: 3.32, 95% CI, 1.38-7.98 and OR: 3.93, 95% CI: 1.82-8.49, respectively). Conclusions: Detection of an MDR pathogen, rather than host factors such as old age, bedridden status, and comorbidities, was the most important risk factor for in-hospital mortality in patients with nursing home pneumonia. Patients with a history of antibiotic use within the previous 3 months had a higher probability of MDR pathogen identification. Identifying MDR pathogens is important in treating older nursing home residents with pneumonia.
Files in This Item:
T202100984.pdf Download
DOI
10.1016/j.archger.2021.104394
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Su Hwan(이수환) ORCID logo https://orcid.org/0000-0002-3487-2574
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/182305
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