Clinical Research Centre, Copenhagen University Hospital, Hvidovre, Kettegård Allé 30, 2650 Hvidovre, Denmark.
Respir Med. 2012 Dec;106(12):1778-87. doi: 10.1016/j.rmed.2012.08.010. Epub 2012 Sep 14.
To evaluate regional differences in and risk factors for admission, length of stay, mortality, and readmission for community-acquired pneumonia in elderly Danish patients.
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.
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.
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 depth investigation in regional differences could reveal potential feasible clinical interventions with an improvement of readmission-, mortality rates and cost.
评估丹麦老年社区获得性肺炎患者入院、住院时间、死亡率和再入院的地区差异及相关风险因素。
本研究为一项全国性登记研究，纳入了 2009 年因社区获得性肺炎急性入院的丹麦老年公民。我们使用 Cox 回归模型，通过年龄、性别、通气支持以及 Charlson 合并症指数评分来调整协变量，研究了住院时间、院内死亡率、出院后 30 天内死亡率和出院后 30 天内再入院率在各医院间的差异。
共纳入 11332 例老年社区获得性肺炎患者。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 天内的再入院率为 12.3%。各医院间的住院时间存在显著差异。Charlson 合并症指数评分高和高龄是住院期间和出院后 30 天内死亡的显著风险因素。男性和 Charlson 合并症指数评分高是再入院的显著风险因素。入住大床位容量医院是死亡和出院后 30 天内再入院的显著风险因素。
丹麦老年社区获得性肺炎患者的住院时间、入院率、死亡率和再入院率与国际研究结果一致。各医院间存在地区差异。深入研究这些地区差异可能揭示出具有改善再入院率、死亡率和成本效益的潜在可行的临床干预措施。
