The Department of Family Medicine, MacKay Memorial Hospital, No. 92, Sec. 2, Zhongshan N. Rd., Zhongshan Dist., Taipei, 104, Taiwan, ROC.
The Department of Medicine, MacKay Medical College, No. 46, Sec. 3, Zhongzheng Rd., Sanzhi Dist, 252, New Taipei City, Taiwan, ROC.
Aging Clin Exp Res. 2020 Jan;32(1):149-155. doi: 10.1007/s40520-019-01169-8. Epub 2019 Mar 14.
Pneumonia is a leading cause of hospitalization and death worldwide. However, studies focusing on risk factors of community-acquired pneumonia (CAP) in the home health care (HHC) population remain scarce.
This study aimed to evaluate risk factors associated with hospitalization for CAP among HHC patients in Taiwan.
This retrospective cross-sectional study extracted data from patients' electronic medical records between 1 January 2017 and 31 December 2017. Multiple logistic regression analyses were performed to explore factors associated with hospitalization for CAP.
In total, 598 patients (men/women: 236/362) were included. One hundred ninety-nine patients (33.28%) were hospitalized for pneumonia. Inpatients showed a higher proportion of the following: male sex, functional impairment, hypoalbuminemia, anemia, nasogastric tube use, excessive polypharmacy, stroke, dementia, heart failure, chronic respiratory disease, and chronic liver disease. Furthermore, nasogastric tube use (odds ratio [OR] 3.01, 95% confidence interval [CI] 1.88-4.82), anemia (OR 2.37, 95% CI 1.48-3.80), male sex (OR 2.14, 95% CI 1.43-3.20), chronic respiratory disease (OR 2.09, 95% CI 1.33-3.30), dementia (OR 1.94, 95% CI 1.27-2.97), heart failure (OR 1.69, 95% CI 1.11-2.56), and hypoalbuminemia (OR 1.57, 95% CI 1.03-2.40) significantly increased the risk of hospitalization for CAP.
Our results revealed risk factors associated with hospitalization for CAP in HHC patients. In addition to chronic diseases, malnutrition is an important risk factor. Caregivers should make prompt assessments and take preventive measures for such patients.
肺炎是全球范围内导致住院和死亡的主要原因。然而，针对家庭保健（HHC）人群中社区获得性肺炎（CAP）的危险因素的研究仍然很少。
本研究旨在评估台湾 HHC 患者中 CAP 住院相关的危险因素。
本回顾性横断面研究从 2017 年 1 月 1 日至 2017 年 12 月 31 日期间患者的电子病历中提取数据。采用多因素逻辑回归分析探讨与 CAP 住院相关的因素。
共纳入 598 例患者（男/女：236/362）。199 例（33.28%）患者因肺炎住院。住院患者中男性、功能障碍、低白蛋白血症、贫血、鼻胃管使用、过度多药治疗、中风、痴呆、心力衰竭、慢性呼吸系统疾病和慢性肝病的比例更高。此外，鼻胃管使用（比值比[OR]3.01，95%置信区间[CI]1.88-4.82）、贫血（OR 2.37，95% CI 1.48-3.80）、男性（OR 2.14，95% CI 1.43-3.20）、慢性呼吸系统疾病（OR 2.09，95% CI 1.33-3.30）、痴呆（OR 1.94，95% CI 1.27-2.97）、心力衰竭（OR 1.69，95% CI 1.11-2.56）和低白蛋白血症（OR 1.57，95% CI 1.03-2.40）显著增加 CAP 住院的风险。
本研究结果揭示了 HHC 患者 CAP 住院的相关危险因素。除慢性疾病外，营养不良也是一个重要的危险因素。护理人员应及时评估并对这些患者采取预防措施。
