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西班牙社区获得性和非呼吸机相关性医院获得性肺炎的住院治疗:支气管扩张症的影响。一项回顾性数据库研究。

Hospitalizations for Community-Acquired and Non-Ventilator-Associated Hospital-Acquired Pneumonia in Spain: Influence of the Presence of Bronchiectasis. A Retrospective Database Study.

作者信息

Sanchez-Muñoz Gema, López-de-Andrés Ana, Hernández-Barrera Valentín, Pedraza-Serrano Fernando, Jimenez-Garcia Rodrigo, Lopez-Herranz Marta, Puente-Maestu Luis, Miguel-Diez Javier de

机构信息

Respiratory Department, Hospital General Universitario Gregorio Marañón, Facultad de Medicina, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), 28009 Madrid, Spain.

Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, 28922 Madrid, Spain.

出版信息

J Clin Med. 2020 Jul 22;9(8):2339. doi: 10.3390/jcm9082339.

Abstract

To examine and compare in-hospital mortality (IHM) of community-acquired pneumonia (CAP) and non-ventilator hospital-acquired pneumonia (NV-HAP) among patients with or without bronchiectasis (BQ) using propensity score matching. A retrospective observational epidemiological study using the Spanish Hospital Discharge Records, 2016-17. We identified 257,455 admissions with CAP (3.97% with BQ) and 17,069 with NV-HAP (2.07% with BQ). Patients with CAP and BQ had less comorbidity, lower IHM, and a longer mean length of hospital stay ( < 0.001) than non-BQ patients. They had a higher number of isolated microorganisms, including . In patients with BQ and NV-HAP, no differences were observed with respect to comorbidity, in-hospital mortality (IHM), or mean length of stay. was more frequent ( = 0.028). IHM for CAP and NV-HAP with BQ was 7.89% and 20.06%, respectively. The factors associated with IHM in CAP with BQ were age, comorbidity, pressure ulcers, surgery, dialysis, and invasive ventilation, whereas in NV-HAP with BQ, the determinants were age, metastatic cancer, need for dialysis, and invasive ventilation. Patients with CAP and BQ have less comorbidity, lower IHM and a longer mean length of hospital stay than non-BQ patients. However, they had a higher number of isolated microorganisms, including . In patients with BQ and NV-HAP, no differences were observed with respect to comorbidity, in-hospital mortality, or mean length of stay, but they had a greater frequency of infection by than non-BQ patients. Predictors of IHM for both types of pneumonia among BQ patients included dialysis and invasive ventilation.

摘要

采用倾向评分匹配法,研究并比较合并或不合并支气管扩张(BQ)的社区获得性肺炎(CAP)和非呼吸机相关性医院获得性肺炎(NV-HAP)患者的院内死亡率(IHM)。这是一项利用2016 - 2017年西班牙医院出院记录进行的回顾性观察性流行病学研究。我们确定了257455例CAP住院患者(3.97%合并BQ)和17069例NV-HAP住院患者(2.07%合并BQ)。合并BQ的CAP患者比未合并BQ的患者合并症更少、IHM更低、平均住院时间更长(P<0.001)。他们分离出的微生物种类更多,包括……。在合并BQ的NV-HAP患者中,在合并症、院内死亡率(IHM)或平均住院时间方面未观察到差异。……更常见(P = 0.028)。合并BQ的CAP和NV-HAP的IHM分别为7.89%和20.06%。合并BQ的CAP中与IHM相关的因素为年龄、合并症、压疮、手术、透析和有创通气,而在合并BQ的NV-HAP中,决定因素为年龄、转移性癌症、透析需求和有创通气。合并BQ的CAP患者比未合并BQ的患者合并症更少、IHM更低、平均住院时间更长。然而,他们分离出的微生物种类更多,包括……。在合并BQ的NV-HAP患者中,在合并症、院内死亡率或平均住院时间方面未观察到差异,但他们感染……的频率高于未合并BQ的患者。BQ患者中这两种肺炎类型的IHM预测因素包括透析和有创通气。

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