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老年社区获得性肺炎患者长期住院和死亡风险:日本的一项回顾性研究

Risk for prolonged hospitalization and mortality in aged community acquired pneumonia patients: a retrospective study in Japan.

作者信息

Matsuo Ayako, Takamori Ayako, Kawaura Futoshi, Iwanaga Yasunari, Ono Hitomi, Kobayashi-Watanabe Naomi, Kuwahara Motohisa, Takagi Kuniaki, Nagasawa Zennzou, Fujimoto Kazuma, Hayashi Shinnichiro

机构信息

International University of Health and Welfare Graduate School of Medicine, 137-1 Enokizu, Ookawa-city, Fukuoka 831-8501, Japan.

Divisions of Respirology, Kouhou-kai Takagi Hospital, 141-11 Sakami, Ookawa-city, Fukuoka 831-0016, Japan.

出版信息

J Clin Biochem Nutr. 2020 Nov;67(3):302-306. doi: 10.3164/jcbn.20-85. Epub 2020 Jul 31.

Abstract

The present study aimed to reveal; i) risk for prolonged hospitalization and mortality in aged community acquired pneumonia patients, and ii) whether swallowing ability was related to re-hospitalization. The present retrospective study included 92 patients older than 75 years hospitalized with community acquired pneumonia in Takagi Hospital between April 2017 and March 2018. The patients were classified into 3 groups; discharged within 17 days (group I): hospitalized more than 18 days (group II): died during the hospitalization (group III). Swallowing ability was evaluated if available. Univariate analysis indicated males and body mass index (BMI) in group I ( = 24) were higher than group II ( = 46). Group III ( = 22) had low serum albumin, low BMI, and severe disease progression compared with group I. Multivariate analysis demonstrated that group II BMI was lower than group I [odds ratio (OR) = 1.18,  = 0.042]. Group III had lower serum albumin level compared with group I (OR = 81.01,  = 0.025). Diabetes mellitus ( = 0.009), but not swallowing disability, was risk for readmission. Malnutrition represented by low albumin enhanced mortality rate in the pneumonia patients, and low BMI and diabetes mellitus might increase the pneumonia risk.

摘要

本研究旨在揭示

i)老年社区获得性肺炎患者延长住院时间和死亡的风险,以及ii)吞咽能力是否与再次住院有关。本回顾性研究纳入了2017年4月至2018年3月期间在高木医院因社区获得性肺炎住院的92例75岁以上患者。患者被分为3组:17天内出院(I组);住院超过18天(II组);住院期间死亡(III组)。如有可能,对吞咽能力进行评估。单因素分析表明,I组(n = 24)的男性和体重指数(BMI)高于II组(n = 46)。与I组相比,III组(n = 22)血清白蛋白低、BMI低且疾病进展严重。多因素分析表明,II组BMI低于I组[比值比(OR)= 1.18,P = 0.042]。与I组相比,III组血清白蛋白水平较低(OR = 81.01,P = 0.025)。糖尿病(P = 0.009)而非吞咽障碍是再次入院的风险因素。低白蛋白所代表的营养不良增加了肺炎患者的死亡率,低BMI和糖尿病可能增加患肺炎的风险。

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