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住院吸入性肺炎患者行走能力下降的危险因素。

Risk factors for decreased walking ability in hospitalized patients with aspiration pneumonia.

机构信息

Department of Physical Therapy, School of Health Science, Toyohashi Sozo University, Toyohashi, Japan.

Department of Rehabilitation, Seirei Mikatahara General Hospital, Hamamatsu, Japan.

出版信息

J Int Med Res. 2023 Apr;51(4):3000605231163708. doi: 10.1177/03000605231163708.

DOI:10.1177/03000605231163708
PMID:37013252
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10084548/
Abstract

OBJECTIVE

To evaluate the factors that influence walking ability in patients hospitalized due to aspiration pneumonia.

METHODS

This retrospective observational study evaluated patients hospitalized with aspiration pneumonia. The primary endpoint was preservation of walking ability. Univariate and multivariate logistic regression analyses were performed with the preservation of walking ability as the dependent variable.

RESULTS

A total of 143 patients were enrolled in this study. The patients were divided into two groups: those whose walking ability decreased after hospitalization ( = 61) and those whose walking ability was maintained after hospitalization ( = 82). Multivariate logistic regression analyses showed that A-DROP (odds ratio [OR] 3.006; 95% confidence interval [CI] 1.452, 6.541;  < 0.01), the Geriatric Nutritional Risk Index (OR 0.919; 95% CI 0.875, 0.960; 0.001) and days to initial mobilization (OR 1.221; 95% CI 1.036, 1.531; 0.05) were the independent early predictors for preservation of walking ability.

CONCLUSION

Nutritional status and early mobilization were important risk factors affecting the maintenance of walking ability in patients hospitalized due to aspiration pneumonia. Thus, a combination of nutrition and early rehabilitation is needed for these patients.

REGISTRY OF RESEARCH STUDIES INVOLVING HUMAN SUBJECTS

This study was registered with the University Hospital Medical Information Network Clinical Trial Registry (UMIN 000046923).

摘要

目的

评估影响因吸入性肺炎住院患者行走能力的因素。

方法

本回顾性观察性研究纳入了因吸入性肺炎住院的患者。主要终点为保留行走能力。将保留行走能力作为因变量进行单因素和多因素逻辑回归分析。

结果

共纳入 143 例患者。患者分为两组:住院后行走能力下降组(n=61)和住院后行走能力保持组(n=82)。多因素逻辑回归分析显示,A-DROP(比值比 [OR] 3.006;95%置信区间 [CI] 1.452,6.541;P<0.01)、老年营养风险指数(OR 0.919;95%CI 0.875,0.960;P=0.001)和首次开始活动的天数(OR 1.221;95%CI 1.036,1.531;P=0.05)是保留行走能力的独立早期预测因素。

结论

营养状况和早期活动是影响吸入性肺炎住院患者行走能力维持的重要危险因素。因此,这些患者需要进行营养和早期康复相结合的治疗。

研究注册

本研究在大学医院医疗信息网临床试验注册中心(UMIN 000046923)注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0743/10084548/6c7b2bfee918/10.1177_03000605231163708-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0743/10084548/6c7b2bfee918/10.1177_03000605231163708-fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0743/10084548/6c7b2bfee918/10.1177_03000605231163708-fig1.jpg

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本文引用的文献

1
The severity of nutrition and pneumonia predicts survival in patients with aspiration pneumonia: A retrospective observational study.营养和肺炎的严重程度可预测吸入性肺炎患者的生存情况:一项回顾性观察研究。
Clin Respir J. 2022 Jul;16(7):522-532. doi: 10.1111/crj.13521. Epub 2022 Jul 5.
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Rehabilitative management for aspiration pneumonia in elderly patients.老年患者吸入性肺炎的康复管理
J Gen Fam Med. 2017 Mar 21;18(1):12-15. doi: 10.1002/jgf2.25. eCollection 2017 Mar.
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Prognostic implications of aspiration pneumonia in patients with community acquired pneumonia: A systematic review with meta-analysis.
社区获得性肺炎患者吸入性肺炎的预后意义:系统评价与荟萃分析。
Sci Rep. 2016 Dec 7;6:38097. doi: 10.1038/srep38097.
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Effect of early rehabilitation on activities of daily living in patients with aspiration pneumonia.早期康复对吸入性肺炎患者日常生活活动能力的影响。
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Effects of early physiotherapy with respect to severity of pneumonia of elderly patients admitted to an intensive care unit: a single center study in Japan.早期物理治疗对入住重症监护病房老年患者肺炎严重程度的影响:日本一项单中心研究
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Mobilization in severe sepsis: an integrative review.严重脓毒症中的活动能力:一项综合综述。
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Effect of early rehabilitation by physical therapists on in-hospital mortality after aspiration pneumonia in the elderly.物理治疗师进行早期康复对老年人吸入性肺炎院内死亡率的影响。
Arch Phys Med Rehabil. 2015 Feb;96(2):205-9. doi: 10.1016/j.apmr.2014.09.014. Epub 2014 Oct 7.
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Rehabilitation nutrition for sarcopenia with disability: a combination of both rehabilitation and nutrition care management.康复营养治疗伴失能的肌肉减少症:康复与营养照护管理相结合。
J Cachexia Sarcopenia Muscle. 2014 Dec;5(4):269-77. doi: 10.1007/s13539-014-0162-x. Epub 2014 Sep 16.
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Oropharyngeal dysphagia is a prevalent risk factor for malnutrition in a cohort of older patients admitted with an acute disease to a general hospital.在一所综合医院因急性病入院的老年患者队列中,口咽吞咽困难是营养不良的常见危险因素。
Clin Nutr. 2015 Jun;34(3):436-42. doi: 10.1016/j.clnu.2014.04.014. Epub 2014 May 9.
10
Clinical practice guidelines for nursing- and healthcare-associated pneumonia (NHCAP) [complete translation].护理和医疗保健相关肺炎(NHCAP)临床实践指南[完整翻译]
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